What is the optimal management for preventing saphenous vein graft diseases? - Early results of intravascular angioscopic assessment

Abstract

Background: The predominant mechanism of early failure of saphenous vein grafts (SVG) after coronary bypass remains unclear, so angioscopy was used to identify the morphological changes. Methods and Results: Of the 31 SVGs assessed 15 had both yellow plaque and thrombi, whereas in the remaining 16 SVGs the intima was clear white. The serum low-density lipoprotein cholesterol level was significantly higher in the diseased SVG group. Eight patients of the normal SVG group were prescribed ticlopidine, compared with only 1 from the diseased SVG group (p=0.015). Conclusions: This is the first direct demonstration of yellow plaque and/or thrombosis in SVGs by intravascular angioscopy. In addition to the importance of prescribing statins, it might be vital to also add ticlopidine to aspirin therapy.