CTICasesSaphenous Vein Graft Aneurysm
Imaging findings
Contrast-enhanced chest CT in a patient post-CABG demonstrates a large, round, and low-attenuation mediastinal mass located adjacent to the ascending aorta. The mass contains a central area of contrast enhancement representing a patent lumen, surrounded by extensive mural thrombus, representing a giant saphenous vein graft aneurysm (SVGA). The bypass graft distal to the aneurysm remains patent.
Key takeaways
Saphenous vein graft aneurysm (SVGA) is a rare, late complication of coronary artery bypass grafting (CABG) surgery, occurring years after the initial procedure. SVGAs carry a high risk of rupture, thrombosis, or myocardial infarction. On CT, they present as mediastinal masses that can mimic aortic aneurysms or primary mediastinal tumors, requiring surgical or endovascular repair.
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