Endovascular treatment of a coronary graft pseudoaneurysm
Published in the European Heart Journal Case Reports, the authors present a case of a patient who presents with a large expanding pseudoaneurysm (7 cm × 5 cm). The aetiology of this pseudoaneurysm was iatrogenic in nature, secondary to previous endovascular interventions (PCI).

The patient presented with haemopericardium and haemodynamic instability after saphenous vein bypass grafting. A pseudoaneurysm rapidly expanded from 5 cm to 7 cm over the follow-up period producing compressive mass effect on the lateral right ventricle with transient haemodynamic instability.

The patient’s declining clinical condition did not warrant a redo thoracotomy and sternotomy, so an endovascular approach was deemed to be the best treatment option.

Learning points:-

- In the setting of venous grafts to coronary vessels, a pseudoaneurysm arising from the graft itself remains to be a rare complication but certainly needs to be addressed if clinically symptomatic.

- The use of endovascular embolization techniques is indeed a technically viable alternative with positive outcomes for treatment of specific cases of haemopericardium without the need for thoracotomy and sternotomy.

Read in detail about the case here: https://pxmd.co/LMhHA
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