Distal embolization protection devices are fast becoming an integral part of percutaneous vein graft interventions. The distal elastomeric balloon of the PercuSurge GuardWire system is supposed to be atraumatic to the vessel wall. We report the inadvertent dilation of a moderate distal stenosis at the site of GuardWire balloon inflation while intervening on a critical proximal saphenous vein graft stenosis. This case illustrates that plaque compression and potential vessel wall trauma might occur during the inflation of the PercuSurge GuardWire distal protection balloon.
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