Percutaneous closure of giant saphenous vein graft aneurysm

Abstract Background Aneurysmal dilatation of saphenous vein grafts used for coronary artery bypass grafting is a rare complication. These aneurysms are often large in calibre and pose a risk of rupture with significant haemorrhage. Case summary We describe a case whereby a large saphenous vein graft aneurysm is closed percutaneously using a vascular plug to cease flow and promote thrombosis of the aneurysm whilst reconstructing the occluded native artery to negate ischaemia. Conclusion Saphenous vein graft aneurysms following coronary artery bypass graft are rare and late complications. The preferred modality of closure is via percutaneous approach that requires meticulous planning to achieve a good outcome.