Aprile Glen, Iqbal Adam B, Leibundgut Gregor, Agostoni Pierfrancesco, Iqbal M Bilal
Department of Cardiology, Royal Jubilee Hospital, Victoria, British Columbia, Canada.
Department of Cardiology, University Hospital Basel, Basel, Switzerland.
JACC Case Rep. 2025 Apr 2;30(7):103401. doi: 10.1016/j.jaccas.2025.103401.
Patients with coronary artery bypass surgery will invariably experience graft failure. In this setting, treatment of the native vessel is recommended. After successful native vessel intervention, competitive flow from a patent graft may limit the durability of native vessel intervention, and thus therapeutic graft closure is usually recommended. Graft closure is frequently achieved with coils, but a recognized complication with coils is distal embolization during or after deployment. The presence of disease or tortuosity in grafts may allow stable deployment of coils and prevent this. However, with relatively patent grafts, it may be difficult to deploy coils without a risk of embolization. To overcome this problem, we propose a new technique where we strategically deploy and fashion a partially crushed stent in the body of the graft to serve as a plug to hold coils and prevent distal embolization, called the CRISP (CRushed In situ Stent Plug) technique.
接受冠状动脉搭桥手术的患者总会出现移植血管失败的情况。在这种情况下，建议对自身血管进行治疗。在成功进行自身血管介入治疗后，来自通畅移植血管的竞争性血流可能会限制自身血管介入治疗的持久性，因此通常建议进行治疗性移植血管闭合。移植血管闭合通常通过线圈来实现，但线圈公认的一个并发症是在部署过程中或部署后发生远端栓塞。移植血管中存在病变或迂曲可能会使线圈稳定部署并防止这种情况发生。然而，对于相对通畅的移植血管，可能很难在没有栓塞风险的情况下部署线圈。为了克服这个问题，我们提出了一种新技术，即在移植血管主体中策略性地部署并制作一个部分压碎的支架作为塞子来固定线圈并防止远端栓塞，称为CRISP（原位压碎支架塞）技术。
