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We describe a case of acute myocardial infarction 19\u2009years after coronary artery bypass graft surgery due to acute occlusion of the distal anastomosis of a LIMA graft to the left anterior descending artery. Aspiration thrombectomy failed to remove the thrombus. Laser thrombectomy caused perforation. After drug\u2010eluting and covered stent implantation, antegrade TIMI 3 flow was restored with an uneventful postprocedural course.<\/jats:p>","DOI":"10.1002\/ccd.28322","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T02:02:14Z","timestamp":1556676134000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Challenges associated with treatment of left internal mammary artery graft thrombosis"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-6635","authenticated-orcid":false,"given":"Iosif","family":"Xenogiannis","sequence":"first","affiliation":[{"name":"Minneapolis Heart Institute Abbott Northwestern Hospital  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Vemmou","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Abbott Northwestern Hospital  Minneapolis 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