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来自大隐静脉移植支架断裂的冠状动脉旁路移植假性动脉瘤

Coronary artery bypass graft pseudoaneurysm from saphenous vein graft stent fracture.

作者信息

Mojadidi Mohammad Khalid, Smith Christopher J, Dibu George, Mogali Kiran, Bavry Anthony A, Choi Calvin, Wymer David C

机构信息

Division of Cardiology, Department of Medicine, University of Florida College of Medicine and Malcolm Randall VA Medical Center, Gainesville, FL, USA.

Department of Radiology, University of Florida College of Medicine and Malcolm Randall VA Medical Center, Gainesville, FL, USA.

出版信息

J Cardiol Cases. 2017 Apr 18;15(6):206-208. doi: 10.1016/j.jccase.2017.02.004. eCollection 2017 Jun.

Abstract

Saphenous venous graft (SVG) pseudoaneurysms are a rare complication of coronary artery bypass grafting (CABG). An 85-year-old man with CABG and a distal SVG stent presented with dyspnea. Chest computed tomography (CT) revealed a large partially thrombosed pseudoaneurysm at the distal SVG with stent fracture. Endoluminal exclusion of the distal SVG pseudoaneurysm using a covered stent was performed. Follow-up chest CT and angiography showed persistent pseudoaneurysm filling and enlargement. The SVG proximal to the pseudoaneurysm was embolized with coils to reduce rupture risk. Following embolization, the patient's left ventricular ejection fraction was moderately depressed but the patient remained stable and was discharged. < Saphenous venous graft pseudoaneurysms are a rare post-operative complication of coronary artery bypass graft procedures with a risk of impending rupture if left untreated. Fracture of a vein graft stent is an even further unique etiology of pseudoaneurysms. Covered stents are a practical therapeutic option for the treatment of vein graft pseudoaneurysms, especially in high risk patients who are not surgical candidates.>.

摘要

大隐静脉桥(SVG)假性动脉瘤是冠状动脉旁路移植术(CABG)的一种罕见并发症。一名85岁行CABG且有远端SVG支架的男性患者出现呼吸困难。胸部计算机断层扫描(CT)显示远端SVG处有一个大的部分血栓形成的假性动脉瘤,伴有支架断裂。使用覆膜支架对远端SVG假性动脉瘤进行腔内封堵。随访胸部CT和血管造影显示假性动脉瘤持续充盈并增大。对假性动脉瘤近端的SVG进行弹簧圈栓塞以降低破裂风险。栓塞后,患者左心室射血分数中度降低,但患者病情稳定并出院。<大隐静脉桥假性动脉瘤是冠状动脉旁路移植手术罕见的术后并发症,若不治疗有破裂风险。静脉桥支架断裂是假性动脉瘤更独特的病因。覆膜支架是治疗静脉桥假性动脉瘤的一种实用治疗选择,尤其是对于不适合手术的高危患者。>

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