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Expanding retrograde saphenous vein graft aneurysm treated with endovascular coiling

Dominic J Parry1, Ian C Winburn, Gerald T Wilkins

  • 1Dunedin Public Hospital, Dunedin, Otago, New Zealand. donathanreeves@hotmail.com

The Annals of Thoracic Surgery
|November 25, 2005
PubMed

Insights

Saphenous vein graft aneurysms after bypass surgery can be fatal. Endovascular coiling offers a minimally invasive treatment option, successfully thrombosing an aneurysm via a retrograde approach.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Saphenous vein graft aneurysms are serious complications following coronary artery bypass grafting (CABG).
  • Surgical intervention is typically required for these potentially fatal conditions.
  • Redo CABG procedures carry specific risks, including graft complications.

Observation:

  • A patient developed a saphenous vein graft aneurysm after undergoing redo CABG.
  • The aneurysm formed in a previously bypassed and proximally occluded saphenous vein graft.
  • The target vessel had been revascularized previously.

Findings:

  • Endovascular coiling was successfully employed to treat the saphenous vein graft aneurysm.
  • A retrograde approach was necessary, utilizing a patent left internal mammary artery (LIMA) and left anterior descending (LAD) artery.
  • The procedure resulted in complete thrombosis of the aneurysm.

Implications:

  • Endovascular coiling presents a viable, less invasive alternative to surgery for saphenous vein graft aneurysms.
  • The retrograde approach demonstrates technical feasibility for treating complex graft aneurysms.
  • This case highlights the importance of surveillance and tailored treatment strategies for post-CABG complications.

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