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Successful Revascularization and Coil Embolization of a Massive SVG Aneurysm With Inferior Vena Cava Compression
Migena Disha1, Volker Rudolph1, Mohamed Ayoub1
1Clinic for General and Interventional Cardiology/Angiology, Herz-und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Insights
A rare saphenous vein graft aneurysm (SVGA) compressing the vena cava was successfully treated with a minimally invasive percutaneous approach. This method proved safe and effective for high-risk patients with complex coronary artery bypass graft complications.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Saphenous vein graft aneurysms (SVGA) are rare but serious complications following coronary artery bypass grafting.
- Atherosclerosis is a common underlying factor contributing to SVGA development.
- Compression of adjacent structures, such as the inferior vena cava, can lead to significant clinical manifestations.
Case Summary:
We report a 71-year-old man with a history of coronary artery bypass grafting who presented with exertional angina. Imaging revealed a massive saphenous vein graft aneurysm (SVGA) compressing the inferior vena cava and an occluded right coronary artery. Given the high surgical risk, a percutaneous approach was chosen, including recanalization of the right coronary artery using drug-eluting stents and coil embolization of the SVGA. The intervention was successful, with complete aneurysm occlusion and recovery of adjacent structures.
Discussion:
SVGA is a rare but serious coronary artery bypass graft complication, often linked to atherosclerosis. Treatment options include surgical, percutaneous, or conservative approaches, depending on patient risk. This case highlights the utility of percutaneous management, which is associated with lower mortality rates in high-risk patients.
Take-Home Message:
Percutaneous management of SVGAs can be safe and effective in high-risk patients, emphasizing the importance of experienced interventional teams in complex cases.
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