Localized pulmonary artery compression due to saphenous vein graft perforation during percutaneous coronary intervention.

Saphenous vein graft interventions are recognised as high risk procedures for adverse outcomes. We present a case of a ruptured vein graft causing a focal hematoma that led to pulmonary artery compression and cardiogenic shock without the classical signs of tamponade. Multi-modality imaging revealed the aetiology and the hematoma resolved after the patient received cardio-pulmonary resuscitation during attempted percutaneous drainage. Localized pulmonary artery compression is a rare complication of percutaneous coronary interventions (PCI). Its recognition and management are discussed, with the importance of early detection and urgent invasive management emphasized.