Natural History and Management of Aortocoronary Saphenous Vein Graft Aneurysms

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.

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Katoh

Nozue

Michishita

2015

Percutaneous treatment of a massive saphenous vein graft aneurysm

Knoery

Ashcroft

Smith

et al. 2018

Saphenous vein graft (SVG) aneurysms are a rare, frequently late presenting, potentially fatal complication of coronary artery bypass graft (CABG) surgery. They are often discovered incidentally during radiological tasks such as chest x‐ray or CT but can present clinically with symptoms such as worsening angina and breathlessness as well as complications such as rupture or myocardial infarction. Given the risks if left untreated, consideration should be given to treatment either through percutaneous routes or open surgery. However, because of a lack of strong evidence, there are no definitive guidelines on the treatment of SVG aneurysms. We describe a patient with an extensive cardiac surgical history who presented with angina and breathlessness and was found to have a large SVG aneurysm, subsequently successfully treated with percutaneous coronary intervention with covered stents.

Ruptured saphenous venous graft pseudoaneurysm presenting as a pulsatile chest mass

Rahman

Khan

Hasan

2019

A 72‐year‐old man with prior history of coronary artery bypass grafting and sternal wire infection presented with non‐ST‐segment elevation myocardial infarction. His coronary angiogram revealed stenosis of the distal left main coronary artery (LMCA) and a pseudoaneurysm of saphenous venous graft (SVG) to right posterior descending artery. Patient developed ventricular fibrillation during admission, and postcardiopulmonary resuscitation, a pulsatile chest mass was observed which was diagnosed with computed tomography as a chest wall collection resulting from rupture of the pseudo‐aneurysm. He underwent percutaneous coronary intervention of the LMCA with drug‐eluting stents followed by successful coil embolization of the SVG pseudoaneurysm. Patient had an uneventful recovery postprocedure.