Case 1Summary

Case 1Clinical Data

• 65 years old

• Male

• Hypertension

• Dyslipidemia

Case 1Clinical Data

• 1998: NSTEMI

• CABG in 1998 – 2 internalmamary arteries – LAD and RCA

• Reoperated in 1999 due to occlusion of both grafts – 2 new

venous grafts to LAD and RCA

Case 1Clinical Data

• 2009: New coronary angiogram in the setting of symptomatic

stable coronary disease

• RCA venous graft occluded

• New severe stenosis of circunflex artery

• PCI with 2,25 x 28 mmDES

Case 1Clinical Data

• Unknown data: 3rd coronary angiogram in the setting of

symptomatic stable coronary disease

• Stenosis of LAD venous graft – successful PCI with DES

Case 1Clinical Data

• 2016: 4th coronary angiogram

• Myocardial Perfusion Test: extensive anterior and inferior

ischemiawithout necrosis

Case 1Clinical Data

Case 1Clinical Data

• 2016: 4th coronary angiogram

• Coronary Angiogram

• Restenosis of LAD venous graft stent – PCI with new 3 x

24 mmDES

• Consideration of PCI of the RCA and LAD Chronic Total

Occlusion

Case 1Angiogram – December 2016

Case 1Angiogram – December 2016

Case 1Angiogram – December 2016

Case 1Angiogram – December 2016