Endovascular treatment of an aneurysmal vein graft twenty-six years after infrainguinal revascularization

Open surgical bypass with single-segment greater saphenous vein remains the most durable revascularization option in symptomatic peripheral arterial disease. Aneurysmal degeneration of autologous conduit is quite rare. Herein is reported a case of a 78-year-old man who presented with a pulsatile medial thigh mass twenty-six years after ipsilateral infrainguinal autologous vein bypass grafting for lifestyle-limiting intermittent claudication. This was found to represent aneurysmal degeneration of the proximal vein graft with mural thrombus. He underwent an uneventful percutaneous endovascular venous aneurysm repair with implantation of a covered self-expanding endoprosthesis and preservation of his patent bypass.