Successful treatment of false aneurysm of a saphenous vein bypass graft with fistula to the anterior chest wall using "covered" intracoronary stents

Mahy, I R; Walton, S.

doi:10.1136/hrt.80.5.527

Cited by 25 publications

(9 citation statements)

References 5 publications

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“…Coronary angiography identifies distal runoff and coronary vessels that might require revascularisation during aneurysmorraphy. In the case of small (!2 cm diameter or a diameter less than twice of the nonaneurysmal vein) asymptomatic patent vein graft aneurysms, conservative management or stenting with a covered stent may be reasonable [7][8][9]. We believe that stenting was not an option in any of the presented cases.…”

Section: Discussionmentioning

confidence: 93%

Saphenous vein graft aneurysms; the true, false and ugly!

Nölke

McGovern

Wood

2004

Interactive Cardiovascular and Thoracic Surgery

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The reported incidence of minor dilation of reversed saphenous vein grafts used for coronary artery bypass grafting varies up to 14%, however significant aneurysmal dilation is unusual. We report on the findings and management of a series of four patients with reversed saphenous vein graft aneurysms (rSVG). These cases show some of the salient and very unusual features at presentation. rSVGs are usually asymptomatic (12-47%), however they may present with cough, unstable angina or sudden death. One of our cases presented with haemoptysis, which has only been described once previously in association with a rSVG. Diagnosis is usually done with a combination of chest X-ray, ECHO, coronary angiography and CT or MRA. Management options including coil embolisation, covered stenting and surgery are discussed. The histology of these cases exemplifies the varying pathogenesis for true and false aneurysms. Our recommendation remains that rSVGs should be treated surgically, if they show signs of enlargement, or they become symptomatic.

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Section: Discussionmentioning

confidence: 93%

Saphenous vein graft aneurysms; the true, false and ugly!

Nölke

McGovern

Wood

2004

Interactive Cardiovascular and Thoracic Surgery

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“…Nonetheless, we reserve the use of covered stents to treat catheter related arterial perforations when the selective injection of “thrombin‐blood patch” fails . The successful use of covered stent to exclude SVG aneurysm has been reported by several isolated case reports . We believe that this approach is particularly attractive compared to redo‐cardiac surgery, considering the significantly higher risk involved in patients undergoing reoperation .…”

Section: Discussionmentioning

confidence: 99%

Innovative use of self‐expanded polytetrafluoroethylene endoprosthesis for percutaneous endovascular interventions

Maluenda

Waksman

Bernardo

2012

Cathet Cardio Intervent

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VIABAHN® endoprosthesis (Gore & Associates, Flagstaff, AZ), a nitinol self-expanding polytetrafluoroethylene (PTFE) lined stent, has demonstrated utility for percutaneous treatment of chronic occlusive disease involving the superficial femoral artery. In a case series communication we aimed to describe the feasibility of a PTFE-lined stent for percutaneous treatment of conditions other than chronic occlusive disease. We report the successful use of PTFE-endoprosthesis to percutaneously treat several vascular conditions, including arterio-venous fistula closure, reconstruction of a distal limb of an aorto-femoral endoprosthesis aneurysm, femoral artery perforation repair, and an exclusion of large saphenous vein graft aorto-coronary bypass aneurysm. This case series illustrates the feasibility of the "off-label" use of self-expanded PTFE endoprosthesis to percutaneously treat several conditions, which would otherwise require "open" surgical reconstructions.

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“…[ 1 ] Psuedoaneurysms are typically saccular, occur early in the post-operative period, and are near the sites of anastamosis. [ 1 ] The significance of this distinction is not purely academic as pseudoaneurysms may lend themselves to more successful treatment utilizing minimally invasive procedures such as covered stent placement, [ 5 ] or coil embolization. [ 6 ] In contradistinction, true fusiform aneurysms will typically require a surgical approach for correction, [ 6 ] as was the case with our patient in which intervention at coronary angiography could not be attempted.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment for SVGA remains a difficult question, and certainly depends upon multiple critical clinical parameters. As we have seen, some SVGA may be successfully treated percutaneously with methods such as coiling [ 6 ] or covered stents, [ 5 ] however, percutaneous treatment is not without problems, even in seemingly appropriate clinical settings. Part of the difficulty in defining optimal treatment is the rarity of the condition, combined with the frequently asymptomatic nature of the condition, and the potential morbidity and or mortality associated with the treatment options.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] Similar to aneurysms in any location, these aneurysms may be true or pseudoaneurysms, [ 1 , 6 ] with specific characteristics and risks factors for each, and different therapeutic options. [ 1 , 5 , 6 ] The rather dramatic increase in published reports of this condition certainly suggests that we are diagnosing this often asymptomatic condition as a result of increased utilization of imaging for a variety of idications. [ 9 ] Other intriguing possibilities include an increase in the true incidence of this condition as a result of factors such as alteration in surgical technique.…”

Section: Discussionmentioning

confidence: 99%

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