Yamaguchi Tetsuo, Miyamoto Takamichi, Kawahatsu Kandoh, Nozato Toshihiro
Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
BMJ Case Rep. 2017 Jul 19;2017:bcr-2017-220443. doi: 10.1136/bcr-2017-220443.
A 73-year-old man, who had undergone coronary artery bypass grafting (CABG) 10 days prior, presented with a great saphenous vein graft aneurysm (SVGA). CT revealed the increasing size of the aneurysm. Since the SVGA occurred immediately after CABG and there were no other complications, the aneurysm was treated percutaneously. While intravascular ultrasonography (IVUS) and optical coherence tomography failed to detect the entry point, an IVUS catheter with the addition of ChromaFlo imaging clearly revealed the entry point, size and length of the SVGA. To prevent migration and edge restenosis associated with covered stents, the covered stent (3.0×19 mm) was superimposed on a drug-eluting stent (3.0×28 mm) that covered the entry site. A follow-up study demonstrated the absence of flow into the aneurysm.
一名73岁男性，10天前接受了冠状动脉旁路移植术（CABG），出现了大隐静脉移植血管动脉瘤（SVGA）。CT显示动脉瘤大小在增加。由于SVGA在CABG后立即出现且无其他并发症，遂对该动脉瘤进行了经皮治疗。虽然血管内超声（IVUS）和光学相干断层扫描未能检测到入口点，但添加了ChromaFlo成像的IVUS导管清晰地显示了SVGA的入口点、大小和长度。为防止与覆膜支架相关的移位和边缘再狭窄，将覆膜支架（3.0×19毫米）叠加在覆盖入口部位的药物洗脱支架（3.0×28毫米）上。一项随访研究表明动脉瘤内无血流。
