PMC4379641_01
Angiogram revealing significant stenosis in saphenous vein graft to major obtuse marginal branch (arrow, Panel A). Angiogram showing drug eluting stent positioned across the lesion (arrow, Panel B)
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F1
After informed consent, coronary angiography by right transradial approach revealed native triple vessel disease, patent LIMA-LAD graft, patent radial-RCA graft, and significant short discrete eccentric lesion in SVG-OM graft distal to the patent stent [arrow, Figure 1a; S Video 1]. The stent 3.5 x 18 mm Xience Pro (Abbott Vascular, Santa Clara, CA) was positioned across the lesion (arrow, Figure 1b).
Angiogram while deploying the drug eluting stent at high pressure causing class III perforation (arrow)
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F2
III perforation at the stent site [arrow, Figure 2; S Video 2]. Immediately, the perforation was occluded proximally with the same stent balloon.
Final angiogram after deployment of covered stent showing complete sealing of the perforation
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F3
Even after prolonged balloon inflation there was still persistent leakage and therefore, the perforation was sealed with 3 x 18 mm covered stent at 12 atmosphere (Jostent Graftmaster, Abbott Vascular, Santa Clara, CA) with TIMI III flow [Figure 3; S Video 3].