Mechanical thrombectomy in coronary artery and saphenous vein graft interventions: a review and case studies.

Atherosclerotic coronary lesions complicated with obstructing thrombus are associated with an increased rate of acute complications and poorer long-term patency after percutaneous balloon angioplasty. Saphenous vein graft (SVG) percutaneous coronary intervention (PCI) has remained a daunting task given the friable nature of the large plaque burdens and unpredictable issues of embolization and no-reflow. These events are associated with increased morbidity including myocardial infarction and death. Today, in both native and autologous SVG lesions, mechanical thrombectomy has become a primary tool for removal of clot prior to PCI. Some studies have shown that mechanical thrombectomy prior to PCI is safe and effective to reduce poor outcomes with PCI in patients with acute coronary syndromes complicated by thrombus in both vein grafts and native coronary arteries.