Emergency balloon angioplasty and digital subtraction angiography in the management of an acute iatrogenic occlusive dissection of a saphenous vein graft.

A 63-year-old male with status post quadruple aortocoronary bypass surgery suddenly complained of chest pain and had ST-segment elevation in lead III during routine coronary angiography. Subsequent selective injections showed occlusion of the bypass graft to the right coronary artery, whereas by digital angiography done 15 min earlier it had been patient. Iatrogenic dissection of the graft was assumed, and balloon recanalization was immediately performed. Chest pain and signs of ischemia rapidly resolved, and no evidence of myocardial infarction was found until hospital discharge.