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May 15, 2026Journal of the American College of Cardiology27 citations

Management of Patients With Aortocoronary Saphenous Vein Graft Aneurysms

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MVMattia VinciguerraCSCristiano SpadaccioCTCharlene Tennyson

Key Result

Management strategies for saphenous vein graft aneurysms have expanded over the last 45 years due to improved diagnostic tools, leading to a proposed clinical algorithm to guide decision-making.

Key Points

  • This review aims to update the understanding of the clinical presentation, diagnosis, and treatment of saphenous vein graft aneurysms (SVGAs) post-CABG.
  • Review of literature on clinical presentation, diagnosis, and management strategies of SVGAs.
  • Emphasis on advancements in diagnostic tools, specifically computed tomographic scanning.
  • Proposal of a clinical algorithm for decision-making and management.
  • Identification of SVGAs can range from incidental findings to life-threatening conditions due to rupture.
  • Improvements in diagnostic imaging have facilitated earlier detection and management options.
  • An updated algorithm has been proposed to guide clinicians in managing SVGAs effectively.

Structured PICO

P
Population
Patients with aortocoronary saphenous vein graft aneurysms (SVGAs) following coronary artery bypass grafting (CABG) surgery
I
Intervention
Management strategies including diagnostic tools (e.g., multislice computed tomographic scanning) and treatment options

This review provides an updated overview and a proposed clinical algorithm for the management of rare but potentially life-threatening saphenous vein graft aneurysms following CABG.

Abstract

Saphenous vein graft aneurysms (SVGAs) following coronary artery bypass grafting (CABG) surgery were first described in 1975. Although rare, in the absence of a prompt diagnosis, SVGAs can be responsible for serious complications and adverse outcomes. The clinical presentation of SVGAs described in the literature can vary from an asymptomatic patient with an incidental radiological finding to a profoundly shocked patient with life-threatening hemorrhage secondary to SVGA rupture. Improvements in diagnostic tools within the last decade, such as multislice computed tomographic scanning, has enabled early detection of SVGAs, and therefore, an expansion of the current management options. In this review, the current data and knowledge about clinical presentation, diagnosis, natural history, and treatment of SVGAs are updated, with a specific emphasis on the evolution of management strategies of this rare complication over the last 45 years. Finally, a clinical algorithm to guide decision-making and management is proposed.

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Cite This Study

Vinciguerra et al. (2021) conducted a review in Saphenous vein graft aneurysms. Management strategies was evaluated. Management strategies for saphenous vein graft aneurysms have expanded over the last 45 years due to improved diagnostic tools, leading to a proposed clinical algorithm to guide decision-making.

synapsesocial.com/papers/6a078dc8d9ec3070f22dd5f9https://doi.org/10.1016/j.jacc.2021.03.009
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