Conservative vs. invasive treatment of aortocoronary saphenous vein graft aneurysms: treatment algorithm based upon a large series

Dieter, Robert S.; Patel, Asha; Yandow, Donald R.; Pacanowski, John P.; Bhattacharya, Abhik; Gimelli, Giorgio; Kosolcharoen, Peter; Russell, Debra

doi:10.1016/s0967-2109(03)00108-x

Cited by 80 publications

(74 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Medical treatment for atherosclerotic disease is, hence, recommended as primary treatment (4,11). Antiplatelet, cholesterol lowering and antihypertensive drugs are standard of care in the treatment (4,11).…”

Section: Resultsmentioning

confidence: 99%

Saphenous Vein Graft Aneurysms

Kang¹,

Kang²

2012

Aneurysm

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Saphenous Vein Graft Aneurysms

Kang¹,

Kang²

2012

Aneurysm

View full text Add to dashboard Cite

“…Strategy of treatment for SVG aneurysm has not been fully established because of small number of case reports about SVG aneurysm. SVG aneurysm had been generally treated with surgical repair 2, 3. Patients with other surgical indications (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…However, giant aneurysm of the SVG is a rare complication of coronary artery bypass surgery, with an overall incidence of <1% 2, 3. Although SVG aneurysms are often incidentally identified on any type of imaging modality, there are some reports about cases of rupture 4, fistula formation with neighboring anatomy 5, and hemodynamic compromise resulting from compression of adjacent cardiac and vascular structures 6.…”

Section: Introductionmentioning

confidence: 99%

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

Katoh

Nozue

Michishita

2015

Cathet Cardio Intervent

View full text Add to dashboard Cite

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.

show abstract

“…4 However, endovascular approaches in SVGA have also been reported. 7 Here we report a tandem aneurysm of an internal mammary artery bypass graft, incidentally detected 17 years following the original procedure. Apart from generalised atherosclerotic disease, the patient had no other illnesses that may lead to aneurysm formation; specifically, there was no evidence of Marfan disease, fibromuscular dysplasia or Takayasu arteritis.…”

mentioning

confidence: 92%

Tandem aneurysms of an internal mammary-aortocoronary bypass graft

Gossner

Larsen²

2009

NHJL

View full text Add to dashboard Cite

Graft aneurysms following aortocoronary surgery are a rare occurrence in clinical practice. Reported cases have mostly involved saphenous vein grafts. Here we report the rare finding of a tandem aneurysm of an internal mammary artery graft which was incidentally detected 17 years following bypass surgery. (Neth Heart J 2009;17:300-2.)Keywords: aneurysm, coronary artery bypass grafting, internal mammary artery, spiral computed tomography A 69-year-old male patient was admitted to the accident and emergency department at Klinikum Braunschweig (Germany) because of recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy revealed a duodenal ulcer which was treated by coagulation. Thereafter, the patient was admitted to the intensive care unit for blood transfusions and observation. His past medical history included aortic valve replacement 13 years ago as well as aortocoronary bypass surgery 17 years earlier with an internal mammary artery graft to the left anterior descending artery and two further venous bypass grafts; carotid endarterectomy for symptomatic stenosis was performed at the same time. His cardiovascular risk factors included hyperlipidaemia and arterial hypertension.Upon his admission to the intensive care unit, a chest radiograph was obtained, which showed a well-defined soft tissue-density mass, apparently arising from the left heart border ( figure 1). An echocardiogram did not yield further information and a contrast mediumenhanced chest CT was therefore arranged for further evaluation. A helical acquisition using a 16-slice scanner (Siemens Somatom 16, Siemens Medical Systems, Erlangen, Germany) revealed a tandem aneurysm of the internal mammary artery bypass graft (figure 2): more proximally, a small, non-perfused aneurysm with a maximum diameter of 2.2 cm and, distally, a second aneurysm with a maximum diameter of 5.7 cm, corresponding to the pericardial mass on the chest X-ray. The larger aneurysm was partly perfused. On the thin-section primary reconstructions the connection between the larger aneurysm and the internal mammary artery could be seen. Formal catheter coronary arteriography provided no additional information regarding the aneurysms; specifically, no further aneurysm of a coronary artery was detected. Both the venous bypass grafts were occluded. Despite being asymptomatic, an operative revision was advised. Intraoperatively, the aneurysms of the internal mammary artery bypass were confirmed and could be resected. The patient made an uneventful recovery and could leave hospital for rehabilitative therapy soon thereafter.Discussion Graft aneurysms are rare following aortocoronary bypass surgery. These have mostly been case reports in the context of saphenous venous graft aneurysms (SVGA). Given that, the true incidence of SVGA is unclear. 1 As in our case, most saphenous vein graft aneurysms are found incidentally; however, their rupture may constitute a fatal complication. 1,2 In contrast, aneurysms of internal mammary artery are rare. In native vessels aneurysms...

show abstract

Conservative vs. invasive treatment of aortocoronary saphenous vein graft aneurysms: treatment algorithm based upon a large series

Cited by 80 publications

References 29 publications

Saphenous Vein Graft Aneurysms

Saphenous Vein Graft Aneurysms

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

Tandem aneurysms of an internal mammary-aortocoronary bypass graft

Contact Info

Product

Resources

About