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Excimer laser for a highly stenotic saphenous vein graft: evidence of debulking by optical coherence tomography

EuroIntervention 2014;9:1484 published online ahead of print July 2013. DOI: 10.4244/EIJV9I12A249

Giampaolo Niccoli
Giampaolo Niccoli*, MD, PhD, FESC; Luca Di Vito, MD; Rocco Antonio Montone, MD; Italo Porto, MD, PhD; Filippo Crea, MD, PhD, FESC, FACC
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
A 73-year-old woman with a history of coronary artery bypass (saphenous vein graft [SVG] for left anterior descending artery [LAD] and right coronary artery) was admitted for non-ST-elevation acute coronary syndrome. Coronary angiography showed a proximal severe stenosis of the SVG for LAD that was the culprit lesion of the acute coronary syndrome (Figure 1A). Frequency-domain optical coherence tomography (FD-OCT) was performed using a non-occlusive technique and showed a highly fibrous stenosis of the SVG (MLA 0.7 mm2) (Figure 1B-E) that was debulked with excimer laser coronary atherectomy (ELCA) (Figure 1-A’,B’). However, a thrombus occurred at the lesion site immediately ...

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