Percutaneous coronary intervention (PCI) in saphenous vein grafts (SVGs) remains one of the most technically demanding scenarios in interventional cardiology. Friable plaques, heavy thrombus burden, distal embolization, and the risk of no-reflow often make achieving successful reperfusion extremely challenging. A compelling case published in the European Heart Journal – Case Reports showcases an innovative bailout strategy in a patient presenting with acute thrombotic occlusion of an SVG following previous CABG.
Despite guideline-directed pharmacotherapy and conventional thrombus aspiration, a large residual thrombus persisted with poor distal flow. The interventional team employed a novel double-wire guide catheter thrombosuction technique, allowing deep guide catheter intubation while maintaining distal vessel access. This facilitated aspiration of a substantial thrombus burden,…
