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经皮治疗巨大隐静脉移植物动脉瘤。

Percutaneous treatment of a massive saphenous vein graft aneurysm.

机构信息

Raigmore Hospital, Inverness, United Kingdom.

Department of Diabetes & Cardiovascular Science, University of the Highlands and Islands, Centre for Health Science, Inverness, United Kingdom.

出版信息

Catheter Cardiovasc Interv. 2019 Apr 1;93(5):923-926. doi: 10.1002/ccd.28040. Epub 2018 Dec 27.

Abstract

Saphenous vein graft (SVG) aneurysms are a rare, frequently late presenting, potentially fatal complication of coronary artery bypass graft (CABG) surgery. They are often discovered incidentally during radiological tasks such as chest x-ray or CT but can present clinically with symptoms such as worsening angina and breathlessness as well as complications such as rupture or myocardial infarction. Given the risks if left untreated, consideration should be given to treatment either through percutaneous routes or open surgery. However, because of a lack of strong evidence, there are no definitive guidelines on the treatment of SVG aneurysms. We describe a patient with an extensive cardiac surgical history who presented with angina and breathlessness and was found to have a large SVG aneurysm, subsequently successfully treated with percutaneous coronary intervention with covered stents.

摘要

大隐静脉移植物(SVG)动脉瘤是冠状动脉旁路移植术(CABG)后一种罕见的、常表现为迟发性、潜在致命的并发症。它们通常在放射学任务(如胸部 X 光或 CT)中偶然发现,但也可能会出现临床症状,如心绞痛和呼吸困难加重,以及破裂或心肌梗死等并发症。鉴于未治疗的风险,如果有治疗的考虑,应通过经皮途径或开放性手术进行治疗。然而,由于缺乏强有力的证据,对于 SVG 动脉瘤的治疗尚无明确的指南。我们描述了一位有广泛心脏手术史的患者,他表现为心绞痛和呼吸困难,发现有一个大的 SVG 动脉瘤,随后通过经皮冠状动脉介入治疗用带覆盖支架成功治疗。

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