A case of giant saphenous vein graft aneurysm successfully treated with catheter intervention

Abstract

The patient was a 67‐year‐old man who had undergone coronary artery bypass graft surgery using a saphenous vein graft (SVG) 22 years before. Computed tomography angiogram revealed a large aneurysm of the SVG (38 × 42 mm in diameter; 80‐mm long) and total occlusion of the left anterior descending artery (LAD). We first performed percutaneous coronary intervention for chronic total occlusion of the native LAD with bi‐directional approach via the SVG. One month later, we performed the trans‐catheter embolization of the SVG and occluded the SVG using multiple coils. This case demonstrates that trans‐catheter embolization after recanalization of native coronary artery is an effective strategy to treat an SVG aneurysm. © 2015 Wiley Periodicals, Inc.

Percutaneous treatment of saphenous vein graft aneurysm: Contemporary procedural considerations

“…Familiarity with, and access to, such devices is critical when addressing SVGA. While coils have been described for both occlusion of the aneurysm as well as the vein graft itself after successful revascularization of the native vessel, coil delivery is not without risk of device embolization, noting technical challenges of coil deployment and procedural skillset which may not be routinely available . Although the indication for treatment and the best treatment modality for saphenous venous aneurysms still needs to be defined, covered stents can be safely used in suitable anatomy as an alternative to surgery .…”

Case report: Unusual presentation of haemopericardium with haemodynamic instability secondary to a coronary graft pseudoaneurysm treated by an endovascular approach

“…Emergent open surgical treatment for these patients is high risk and should be avoided, especially in patients who are unstable at presentation 2 , 3 . The use of endovascular embolization techniques is indeed a technically viable alternative with positive outcomes without the need for thoracotomy and sternotomy 4 , 5 …”

Percutaneous Closure of the Aorto-Ostial Origin of a Coronary Artery Saphenous Bypass Graft with a Large Pseudoaneurysm Using the AMPLATZER Muscular Ventricular Septal Defect Occluder

“…Therapeutic options such as coil embolization or closure with a stent graft have been reported. 3,7,9,16,17 However, coil embolization is likely to be effective in a small pseudoaneurysm, and stent graft is best applied in a patent graft supplying a viable myocardium where graft closure can lead to significant ischemia. Closure of an aortic pseudoaneurysm with an AMPLATZER plug has also been described and its application in the setting of a vein graft pseudoaneurysm is exceedingly rare.…”

“…However, endovascular techniques are now more frequently utilized including stent grafts or coil embolization. 3,7,9,16,17 We report a case of an aneurysmal vein graft with subsequent rupture and formation of a large pseudoaneurysm. The AMPLATZER muscular VSD Occluder (St Jude's Medical, St. Paul, MN) was utilized successfully to occlude the aortic origin of the graft.…”