Treatment of saphenous vein graft thrombosis with distal protection, thrombectomy, and adenosine prior to reperfusion: a complete approach to preserving microvascular integrity.

Abstract

We report the treatment of an acute myocardial infarction presenting late with thrombotic total occlusion of a saphenous vein graft. A novel approach was used to prevent microvascular obstruction and reperfusion injury, with a distal protection system, a thrombectomy device, and administration of intracoronary adenosine prior to restoration of flow, so that initial reperfusion was done with maximal microvascular vasodilatation.