CTICasesSaphenous Vein Graft Aneurysm
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Imaging findings
Chest radiography demonstrates fractured median sternotomy wires and a large, well-defined, rounded extrapleural mass located directly behind the sternum, initially suggesting a left internal mammary artery aneurysm. Computed tomography angiography confirms a giant, chronically occluded aneurysm of a saphenous vein graft with a large ball-like appearance and peripheral thrombus, with the left internal mammary artery graft noted to be intact and normal.
Key takeaways
Saphenous vein graft aneurysms are a known complication of prior coronary artery bypass graft surgery, stemming from the inability of venous walls to chronically withstand arterial pressures. While they may radiographically mimic left internal mammary artery aneurysms, computed tomography angiography is essential to define the origin of the aneurysm, assess patency, and rule out chronic occlusion or thrombosis of the bypass graft.
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