A Novel Stent-in-Stent Scaffolding Technique for Percutaneous Exclusion of a Large Saphenous Vein Graft Pseudoaneurysm.

Authors

Mohammad Hamideh, Hafez Golzarian, Alec Rhodes, David B Wong, Khaled Khalaf, Philip LaCombe

Published in

JACC. Case reports. Pages 110416. Sep 23, 2026. Epub Sep 23, 2026.

Abstract

Saphenous vein graft (SVG) pseudoaneurysms are rare late complications of coronary artery bypass grafting associated with rupture and embolization.
A 64-year-old woman presented with progressive dyspnea and chest pain 16 years after coronary artery bypass grafting. Computed tomography demonstrated a large-necked pseudoaneurysm of the proximal SVG. Given her high surgical risk and anatomy unsuitable for coverage with a single covered stent, intravascular ultrasound-guided percutaneous exclusion was performed using a novel dual-stent scaffolding technique. A long drug-eluting stent provided structural support for subsequent covered stent deployment, successfully excluding the pseudoaneurysm with TIMI flow grade 3.
Complex SVG pseudoaneurysms with large necks may challenge conventional covered stent strategies. Dual-stent scaffolding provides a stable landing zone and structural support for percutaneous exclusion.
Intravascular ultrasound-guided dual-stent scaffolding may offer a feasible strategy for complex SVG pseudoaneurysms in high-risk surgical patients.

PMID:
42776118
Bibliographic data and abstract were imported from PubMed on 23 Sep 2026.

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