Directional atherectomy for retained valves in a femoropopliteal saphenous vein bypass graft

We describe the case of a 62-year-old man presenting 2 months after a reversed great saphenous vein femoropopliteal bypass performed for critical limb ischemia. He was found to have early, high-grade bypass graft stenosis on duplex ultrasound. Subsequent angiography demonstrated flow limitations sec...

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Bibliographic Details
Published inJournal of vascular surgery cases and innovative techniques Vol. 10; no. 2; p. 101406
Main Authors Subramanian, Tanvi, Weiss, Robert, Jun Lee, Cheong
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.04.2024
Elsevier
Subjects
Atherectomy
Case report
Critical limb ischemia
Endovascular
Saphenous vein graft
Atherectomy
Critical limb ischemia
Saphenous vein graft
Endovascular
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Summary:We describe the case of a 62-year-old man presenting 2 months after a reversed great saphenous vein femoropopliteal bypass performed for critical limb ischemia. He was found to have early, high-grade bypass graft stenosis on duplex ultrasound. Subsequent angiography demonstrated flow limitations secondary to two areas of retained venous valves in the proximal and mid-portions of the vein graft. The culprit valve lesions were successfully lysed endovascularly with a HawkOne (Medtronic) directional atherectomy device. This case demonstrates a safe, novel use of a directional atherectomy device for treatment of remnant valves causing hemodynamically significant flow problems in peripheral vein grafts.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2023.101406