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How I Deal With... SVGs. Simon Redwood St Thomas’. No Conflict of Interest to Declare. Mr PM, 55 years old CABG 1993 SVG – LAD SVG – OM2 8F LCB. How should we tackle this?. Laser Catheter. 0.9, 1.4. 1.7. 2.0 mm diameter. Particle Size post 308 nm ablation. 5% : > 5 - <12 micron.

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How I Deal With...SVGs

Simon Redwood

St Thomas’



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Laser Catheter

0.9, 1.4. 1.7. 2.0 mm diameter


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Particle Size post 308 nm ablation

5% : > 5 - <12 micron

50% : < 1 micron

45% : 1 – 5 micron

Erytrocyte = 7µ


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Saline Infusion Protocol

In order to obtain an optimal contact between catheter tip and lesion it is mandatory to implement the saline infusion protocol.

15-20 ml saline bolus after each contrast injection

15-20 ml saline flush during every laseractivation (5 sec)


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Saline Infusion

Images taken from the DVD: Critical Limb Ischemia, New Techniques For Complex Interventions, Prof. Dr. Giancarlo Biamino - Dr. Dierk Scheinert (Herzzentrum Leipzig) Michael Jaff, MD (Lennox Hill, NY)


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  • Mr JN, 64 years old

  • CABG 1988

  • LIMA – LAD

  • SVG – RCA and “LCx”

  • Tn +ve ACS

  • Anterolat ST changes

  • LIMA – LAD normal

  • SVG – RCA occluded



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Peak CK 205


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Summary

Conventional wire

Debulk with laser

Filter device

Stent – usually BMS, occ. covered


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