Staged stenting of a long aneurysm of a saphenous vein coronary artery bypass graft

J Invasive Cardiol. 2008 Jan;20(1):E1-5.

Abstract

A 65-year-old male who underwent coronary artery bypass graft surgery (CABG) 21 years ago and received a mitral valve annuloplasty 5 years ago presented with recurrent angina. Computed tomography showed an aneurysm of the saphenous vein graft (SVG), measuring approximately 43 x 33 mm with mural thrombus. Diagnostic catheterization showed that the SVG to the marginal branch of the left circumflex artery had a large aneurysm with mural thrombus, which measured 32 x 45 mm. The lesion was pretreated with a 5.5 x 47 mm Magic Wallstent (Boston Scientific, Maple Grove, Minnesota) followed by 4.0 x 26, 4. x 26, 4.0 x 19 and 4.0 x 16 mm PTFE-covered stents. Postdilatation was performed using a 5.0 x 20 mm balloon. Because of significant flow from the distal end of the PTFE-covered stents seen at coronary angiography after 6 months, we implanted another 4.0 x 26 mm PTFE-covered stent at the distal edge of the previous stent. Final angiography and intravascular ultrasound showed no significant flow into the aneurysm.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Angina Pectoris / diagnosis
  • Angina Pectoris / etiology
  • Angioplasty, Balloon, Coronary / methods*
  • Cardiac Catheterization
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / etiology
  • Coronary Aneurysm / therapy*
  • Coronary Angiography
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / methods
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / surgery*
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Recurrence
  • Risk Assessment
  • Saphenous Vein / transplantation*
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Interventional