Jamshidi Peiman, Resink Therese, Erne Paul
Division of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland.
J Invasive Cardiol. 2008 Jan;20(1):E1-5.
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.
一名65岁男性，21年前接受了冠状动脉旁路移植术（CABG），5年前接受了二尖瓣环成形术，现出现复发性心绞痛。计算机断层扫描显示大隐静脉移植物（SVG）动脉瘤，大小约为43×33mm，伴有壁血栓形成。诊断性心导管检查显示，向左回旋支边缘支供血的SVG存在一个大动脉瘤，伴有壁血栓形成，大小为32×45mm。先用一个5.5×47mm的Magic Wallstent（波士顿科学公司，明尼苏达州枫树谷）对病变进行预处理，随后置入4.0×26、4.0×26、4.0×19和4.0×16mm的聚四氟乙烯覆膜支架。使用一个5.0×20mm的球囊进行后扩张。由于6个月后冠状动脉造影显示聚四氟乙烯覆膜支架远端有大量血流，我们在前一个支架的远端边缘又植入了一个4.0×26mm的聚四氟乙烯覆膜支架。最终血管造影和血管内超声显示动脉瘤内无明显血流。
