Combined surgical and interventional treatment of a giant superior vena cava aneurysm

We report the diagnosis, treatment, and follow-up of a rare giant superior vena cava (SVC) aneurysm in a 39-year-old woman, managed through a combination of surgical and interventional techniques. The patient underwent off-pump SVC aneurysmorrhaphy without cardiopulmonary bypass, followed by balloon angioplasty to address early postoperative stenosis manifested by facial cyanosis. The interventions resulted in complete symptom resolution and durable vessel patency, as confirmed by computed tomography at 3 months and maintained at 1 year. This case highlights that off-pump aneurysmorrhaphy offers a safe, organ-preserving option for large SVC aneurysms with minimal thrombus, and balloon angioplasty serves as an effective salvage therapy for postoperative stenosis. An integrated surgical-interventional strategy, coupled with standardized anticoagulation and imaging follow-up, may optimize outcomes in this rare vascular condition.