Leaking pseudoaneurysm of lower limb saphenous vein graft: a rare complication and its successful treatment by endovascular embolization

Abstract

A rare complication after lower limb revascularization using a saphenous vein bypass graft in a crush injury patient where the saphenous vein graft was the sole supplying vessel to the leg is described; a pseudoaneurysm developed in the saphenous vein graft and caused active profuse bleeding through the surgical wound. The aetiology of this condition is uncertain but it could occur owing to slippage of ligature from one of the tributaries of the saphenous vein. The diagnosis was made by digital subtraction angiography. The pseudoaneurysm was successfully obliterated by glue embolization, which stopped the bleeding immediately, with preservation of distal flow, thereby salvaging the limb.

Endovascular Treatment of Venous Bypass Graft Pseudoaneurysm with the New Solaris Self-Expanding Covered Stent

“…Many infrainguinal bypass grafts are in a subcutaneous position, making surgical repair the most expeditious and desirable procedure. Other minimally invasive treatment options include ultrasound-guided compression, percutaneous thrombin injection, and endovascular treatment [3,4]. In high-risk patients, an endovascular approach is a practical therapeutic method and offers an attractive option because it avoids the need for reoperation in a previously scarred area.…”

Femoropopliteal Bypass Surgery: Great Saphenous Vein Graft Rupture

“…Indications to repair a PA include active hemorrhage, impending compartment syndrome and severe unremitting pain. In high-surgical-risk patients, the placement of a stent graft provides a safe and effective option for the treatment of PA [3,4,5]. Although stenting of PA has been reported in the literature for over a decade, reports of endoluminal stent graft placement to treat false aneurysms of infra-inguinal bypass grafts are few [5].…”