Page 21 - Delaware Medical Journal - December 2015

Pseudoaneurysms may occur early as well as late after initial surgery, at the anastomotic site in most cases. The exact mechanism for the development of such pseudoaneurysms is unclear. Imperfect surgical technique with sutural defects may play a role in some cases occurring relatively early in the postoperative course. Other mechanisms are thought to include damage to the graft wall during initial surgery or weakness in the veins themselves at branch sites or in the areas of the vein valves. One case of false aneurysm that appeared after coronary angioplasty and stenting of a saphenous vein CABG to the LAD suggested that stenting of aged vein grafts might be a cause of aneurysm formation. Infection has also been described as a cause in at least six observations.2
Most of the time, the SVG aneurysms are asymptomatic and are diagnosed incidentally during other procedures.5
FIGURE 4
Repeated Cardiac CT showing thrombosis of the aneurysm with no residual flow.
FIGURE 3
Figure 3A: Small residual flow to the aneurysm after the first stent. Figure 3B: No Residual flow to the aneurysm after a second stent.
Del Med J | December 2015 | Vol. 87 | No. 12 373