Towards a Saphenous Vein Graft Moratorium

Abstract

Atherosclerosis develops and rapidly progresses in saphenous veins grafts after coronary bypass surgery. In contrast to native coronary artery, percutaneous revascularization does not impede the progression of saphenous vein atherosclerosis and saphenous vein graft failure commonly ensues. The protracted patency of arterial grafts is likely to account for most of the long-term superiority of coronary artery bypass surgery over percutaneous revascularization in patients with complex coronary artery disease. Long-lasting, complete coronary revascularization may be best achieved by combining surgical arterial grafting of diseased coronary arteries to percutaneous revascularization with drug-eluting stents than by the continued use of saphenous vein grafts.

Apolipoprotein A-I vascular gene therapy reduces vein-graft atherosclerosis

“… 6 The long-term success of CABG depends on continued patency of the bypass graft conduits. 7 , 8 , 9 However, saphenous vein grafts (SVGs), which account for >80% of CABG conduits and are used in >90% of CABG operations, 10 , 11 have a high rate of stenosis and occlusion, with ∼50% occluded within 10 years. 9 , 12 …”