Case 47: PCI Manual - SVG aneurysm and iliac tortuosity

A patient presented with an enlarging aneurysm in a saphenous vein graft to the right coronary artery. The plan was to attempt recanalization of the native coronary CTO. However, the RCA could not be engaged due to extreme iliac tortuosity and calcification. The SVG was eventually engaged using a diagnostic multipurpose catheter that was exchanged for a guide catheter, but a primary retrograde crossing attempt failed. The patient returned and underwent placement of a Viabahn VBX covered stent to the SVG aneurysm via left radial cutdown with successful sealing of the aneurysm.

[@damirapevec6203]

Very informative case. How were you able to use only 107 ml of contrast in 5h duration of the procedure?

[@hmahmaljy]

Might have been a good case for the use of ranexa lol

[@harshgolwala9935]

We have used Atrium/iCast in similar situation before.

[@manosbrilakis]

This is another great choice - I think that the Viabhan VBX is a little more flexible, but both should work.

[@ahmettemiz2528]

Sir do you know how was the follow up, did stent have thrombotic complications how did you managed DAPT therapy,