Closure of a Giant Saphenous Vein Graft Aneurysm with Embolization Coil

Abstract

Aneurysms of saphenous vein grafts (SVGs) to coronary arteries are rare, usually asymptomatic and found incidentally. We report a case of an 84-year-old female who was found to have 8.1 × 8.4 cm aneurysm of an SVG to obtuse marginal (OM) artery. The aneurysm was prior to the distal anastamosis but no flow into the OM artery was noted. Cook Tornado Embolization Coils were used successfully to occlude the SVG proximal to the aneurysm. No complications occurred. The use of embolization coils is an effective and safe method for aneurysm occlusion when the anatomy is suitable and especially when patient is high risk for repeat surgical intervention.

Angina Leading to Metal in the Heart: An Interesting Case of Saphenous Vein Graft Coiling

“…Early aneurysm formation is defined <12 months after surgery. Late aneurysm formation is defined as >5 years post surgery [1].…”

“…Generally, the aneurysm develops a hematoma and usually involves the proximal and distal ends of the vein graft [3]. Pseudo-aneurysms are generally more common than true aneurysms [1].…”

“…Several percutaneous interventions have been developed to decrease the risk of adverse outcomes from aneurysms. Vascular plugs, coil embolization, covered stunting and alcohol injection into the graft are some techniques used to treat the dilations [1].…”

“…Mainstays of treatment for VGA include conservative management with long-term anti-coagulation and in severe cases, coiling of the aneurysmal dilitations. This case highlights the use of coils in the management and treatment of severe vein graft aneurysms [1].…”

Huge saphenous vein graft aneurysm presenting as non-ST elevation myocardial infarction and compressing the heart

“…The conservative strategy is unsafe because of rupture risk. Re-do surgery seems to be the preferred treatment options according to literature 3 . However, in old patients with various co-morbidities, however, coiling and Amplatzer plugs may be alternative treatment options 4 .…”