Background: The formation of a saphenous vein graft aneurysm is an extremely rare event. It can cause the potential complications similar to arterial aneurysms, such as rupture, thrombosis, distal
embolisation and ischemia leading to limb loss.
Case report: We present a case of a 76-year old man with multiple saccular aneurysms of the femoropopliteal saphenous vein graft, inserted 22 years ago. The echo-Doppler revealed aneurismal dilatations ranging from 2 to 3 cm in diameters, they had endoluminal thrombus. Angiography confirmed
the diagnosis which revealed multiple aneurysmatic dilatations of the saphenous vein graft with severe generalized atherosclerotic changes in the remainder of the graft. At operation, the aneurysmatic saphenous vein graft was removed under spinal anesthesia and the arterial continuity reestablished with an inverted saphenous vein, taken from the contralateral limb. He was perfectly well at the follow-up after nine months.
Conclusions: Venous graft aneurysms should be removed to prevent possible complications, and the arterial
continuity reestablished with a contralateral saphenous vein or synthetic graft. Lifelong follow-up
is mandatory following surgery.

Keywords: Venous aneurysm, saphenous vein graft