Bifurcating saphenous vein aorto-coronary bypass graft lesions: Treatment of left main equivalent using two filterwire EX™ distal protection devices

Distal protection devices for the prevention of embolization during saphenous venous aorto-coronary bypass graft intervention are currently considered standard of care. Branching or Y-type saphenous vein grafts present a unique and challenging problem when a distal protection device is anticipated. We present a case in which two Filterwires™ were used simultaneously through two separate guiding catheters in a left main equivalent bifurcating saphenous vein graft (SVG) with significant ostial and proximal atherosclerotic lesions of both limbs, which supplied left anterior descending artery and circumflex artery territories.