An unusually hard lesion in an aortocoronary saphenous vein graft refractory to standard balloon angioplasty

We report a case of a hard lesion in the body of an aortocoronary saphenous vein graft, which developed 3 years after bypass surgery and was not amenable to dilation during percutaneous coronary angioplasty, despite multiple balloon inflations at pressures reaching 13 atm. Hard lesions in aortocoronary saphenous vein grafts are rare but may lead to balloon angioplasty failure necessitating alternative angioplasty options.