ABSTRACT
Percutaneous revascularization of grafts provides the interventionist with a very diverse range of technical challenges. Perhaps because of the propensity for vein grafts to develop friable atheromatous material and thrombus, even the most apparently straightforward case carries with it the risk of sudden loss of flow due to distal embolization. Such considerations have led to a keen interest into methods for minimizing this, such as direct stenting, and devices for intercepting emboli before they reach the distal coronary. Recently occluded grafts containing a large burden of thrombus can be especially difficult to clear efficiently. Grafts are often performed upon patients who are at higher than average risk for major complications. Extensive areas of disease are often involved, prompting questions about the optimum length to cover with stent and whether some types of stent are especially suitable. The longer term outcome of stented grafts is also less clear than for native vessels.
