case_images: PMC6250038_01
case_images: (a) Coronary angiography of saphenous vein graft. (b) OCT finding at the lesion. (c) IVUS finding at the lesion.
case_images: CRIC2018-5138705.001.jpg
case_images: PMC6250038_01_CRIC2018-5138705.001.jpg
case_images: fig1
case_images: Regarding the bypass graft, the LITA-LAD was patent but the SVG had significant stenosis at the proximal site (Figure 1(a)). The OCT findings also suggested a red thrombus with attenuation (Figure 1(b)). As protruding calcification was detected by IVUS (Figure 1(c)), the lesion was judged as not the red thrombus but the nodular calcification.
case_images: (a) OCT findings before rotablator. (b) OCT findings after ablation with 1.75 mm rotablator burr. (c) OCT findings after ablation with 2.0 mm rotablator burr.
case_images: CRIC2018-5138705.002.jpg
case_images: PMC6250038_01_CRIC2018-5138705.002.jpg
case_images: fig2
case_images: Rotational atherectomy was considered for the treatment of this focal and protruding calcified lesion, although the use of a rotablator for a diffuse degenerative SVG lesion is basically contraindicated.  Figure 2(a) shows the OCT findings preablation, and Figures 2(b) and 2(c) show the postablation OCT findings using 1.75 and 2 mm rotablator burrs, respectively.
case_images: OCT findings after stenting.
case_images: CRIC2018-5138705.003.jpg
case_images: PMC6250038_01_CRIC2018-5138705.003.jpg
case_images: fig3
case_images: A well-apposed and expanded stent was confirmed based on the poststenting OCT findings (Figure 3).
case_images: Final coronary angiography.
case_images: CRIC2018-5138705.004.jpg
case_images: PMC6250038_01_CRIC2018-5138705.004.jpg
case_images: fig4
case_images: The nodular calcification in the SVG was successfully treated by PCI without any complications (Figure 4).