Aneurysm of a subclavian-vertebral artery saphenous vein bypass graft: case report.
OBJECTIVE
Although an autogenous saphenous vein is frequently used as a bypass graft, an aneurysm of a venous graft is a rare complication, especially in the case of cerebrovascular revascularization. We report a case of a successfully treated aneurysmal change in a venous graft after short vein bypass grafting.


METHODS
A 60-year-old man underwent a left subclavian-to-vertebral artery bypass operation with an interposed saphenous vein graft because of severe stenosis of the vertebral artery bilaterally. Angiograms of the left subclavian artery, obtained 4 months later, showed good patency of the graft without any dilation or stenosis. One year after the bypass surgery, the patient became aware of a pulsating mass in the left supraclavicular region, which was regarded as the grafted vein itself. A giant aneurysm of the vein graft, which developed at the nonanastomotic site, was shown in the angiogram 4 years later.


METHODS
The aneurysm was resected, and patch grafting of the orifice of the aneurysmal neck covered with an artificial vessel as a reinforcement was performed.


CONCLUSIONS
The aneurysm seemed to have developed in a curved segment because of hemodynamic stress.
Takeuchi
S
S
Department of Neurosurgery, School of Medicine, Niigata University, Japan.
Abe
H
H
Tanaka
R
R
Hayashi
J
J
D000714:Anastomosis, Surgical; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014680:Veins / Q000473:pathology / Q000637:transplantation*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*