JACC. Case reports · 2026
Hybrid Percutaneous Intervention for a Giant Saphenous Vein Graft Pseudoaneurysm.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ibrahim Mina Assad, Botrous Christina, Wassef Nancy Z K, Suresh Venkatesan
Аннотация
BACKGROUND: Saphenous vein graft (SVG) pseudoaneurysms are uncommon complications of coronary artery bypass grafting that may expand rapidly and cause compression or rupture.
CASE SUMMARY: A 66-year-old man presented with non-ST-segment elevation myocardial infarction. Coronary angiography showed a patent SVG supplying the obtuse marginal branch. Six months later, he re-presented with angina, and imaging revealed a giant 80-mm SVG pseudoaneurysm compressing the pulmonary artery. Laboratory evaluation including erythrocyte sedimentation rate and C-reactive protein was negative. The patient was a surgical turndown including redo sternotomy given high operative risk. A hybrid surgical-percutaneous approach using axillary access enabled deployment of covered and drug-eluting stents, successfully excluding the pseudoaneurysm while preserving graft patency.
DISCUSSION: SVG pseudoaneurysms are rare but potentially fatal. Management depends on rupture risk, myocardial jeopardy, and surgical feasibility. Percutaneous exclusion presents a viable alternative in high-risk surgical patients.
TAKE-HOME MESSAGES: Percutaneous exclusion of SVG pseudoaneurysms may preserve graft patency in high-risk surgical patients. Hybrid access strategies and heart team collaboration are essential in patients with complex vascular anatomy.
CASE SUMMARY: A 66-year-old man presented with non-ST-segment elevation myocardial infarction. Coronary angiography showed a patent SVG supplying the obtuse marginal branch. Six months later, he re-presented with angina, and imaging revealed a giant 80-mm SVG pseudoaneurysm compressing the pulmonary artery. Laboratory evaluation including erythrocyte sedimentation rate and C-reactive protein was negative. The patient was a surgical turndown including redo sternotomy given high operative risk. A hybrid surgical-percutaneous approach using axillary access enabled deployment of covered and drug-eluting stents, successfully excluding the pseudoaneurysm while preserving graft patency.
DISCUSSION: SVG pseudoaneurysms are rare but potentially fatal. Management depends on rupture risk, myocardial jeopardy, and surgical feasibility. Percutaneous exclusion presents a viable alternative in high-risk surgical patients.
TAKE-HOME MESSAGES: Percutaneous exclusion of SVG pseudoaneurysms may preserve graft patency in high-risk surgical patients. Hybrid access strategies and heart team collaboration are essential in patients with complex vascular anatomy.