PMC6431758_01
(a) Baseline view of saphenous vein graft to right coronary artery, with two critical lesions (broad arrows), in proximal and distal, implantation part. (b) Massive extravasation of arterial blood into mediastinum after perforation in proximal segment (c) repaired with polyureathane-covered stent with no contrast leak observed. (d) Chest CT scan presenting spread of contrasting blood into mediastinal space (dotted circle); covered stent's section pointed with dotted arrow. $ External pressure from extravasated blood to distal SVG part resulting in near closure of the vessel; (f) treated with PCI with final result depicted.
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PMC6431758_01_10.1177_2050313X19838745-fig1.jpg
fig1-2050313X19838745
Among grafts, there were two critical lesions in SVG-RCA (Figure 1a), three relevant stenoses in SVG-Cx and also one in LIMA-LAD, with lesions present in all implantation sites. Papyrus 3.5 mm/18 atm) and successful sealing of vascular wall (Figure 1c). Patient was hemodynamically stable; echocardiography revealed no signs of hemopericardium. Prompt ECG-guided chest computed tomography (CT) displayed mediastinal haematoma near the heart base, surrounding large vessels and right heart margin, sparing pleura and pericardium (Figure 1d) No extra contrast during CT imaging was administered. Another immediate CA revealed near occlusion of SVG-RCA distally to covered stent (Figure 1e), which required DES implantation (3.5 x 26 mm/14 atm) (Figure 1f).