Occlusion of a giant saphenous vein graft aneurysm using distal coil embolisation and a proximal vascular plug

An asymptomatic giant true saphenous vein graft aneurysm was successfully occluded by percutaneous distal coil embolisation combined with deployment of a proximal Amplatzer vascular occlusion plug. The aneurysm cavity was excluded from both antegrade flow via the aortosaphenous anastamosis and retrograde flow via the distal left anterior descending coronary artery (supplied by a left internal mammary artery graft), to reduce the risk of subsequent aneurysm rupture.