Development of a saphenous vein coronary artery bypass graft pseudoaneurysm

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Interventional Cardiology

Background:

• Saphenous vein grafts are commonly used in coronary artery bypass grafting (CABG).
• Pseudoaneurysms are rare but serious complications of vascular surgery, including CABG.
• Long-term surveillance is crucial for detecting delayed complications of venous grafts.

Purpose of the Study:

• To report the long-term development and successful endovascular management of a saphenous vein bypass pseudoaneurysm.
• To highlight a rare complication following coronary artery bypass surgery.
• To illustrate the efficacy of covered stent grafts in treating pseudoaneurysms.

Main Methods:

• A patient with a history of CABG for three-vessel coronary artery disease presented with angina.
• Diagnostic angiography revealed a large saphenous vein graft pseudoaneurysm.
• The pseudoaneurysm was treated with endovascular occlusion using a covered stent graft.

Main Results:

• The patient presented with angina, likely due to coronary artery disease progression.
• Angiography confirmed an enlarged saphenous vein graft pseudoaneurysm (approximately 15x8 mm).
• Successful occlusion of the pseudoaneurysm was achieved with a covered stent graft, with no complications at six-month follow-up.

Conclusions:

• Saphenous vein bypass pseudoaneurysms are a rare long-term complication after CABG.
• Endovascular treatment with covered stent grafts offers a safe and effective solution for managing these pseudoaneurysms.
• This case underscores the importance of recognizing and managing delayed graft complications.