Stent Deployment in Old Saphenous Vein Grafts with the Use of a Protection Device

We present two cases of patients with coronary artery disease who had undergone coronary artery bypass surgery and had developed significant disease in the saphenous vein grafts. Coronary angiography revealed complicated lesions in both cases as a result of the age of the grafts, which created a high risk for distal embolization during the interventional procedure. We decided to treat these lesions using un umbrella-type filter protection device (Angioguard) during the angioplasty procedure, in order to capture embolic material and thrombi from the degenerative lesions of these old vein grafts and avoid peripheral obstruction in the microcirculation with all the subsequent consequences. In one of the cases the emboli that were captured were visually detected but in the other no macroscopic emboli were detected. However, both patients were successfully treated without any evidence of distal embolization. The importance of coronary microvasculature protection and the use of such devices that can make coronary interventions safer is discussed in brief.