Saphenous Vein Graft Interventions

Abstract

In patients with prior coronary artery bypass grafting, progression of atherosclerosis and degeneration of the bypasses frequently lead to the need for repeat revascularization. In general, percutaneous revascularization of saphenous vein grafts is associated with a higher rate of periprocedural and in-hospital complications than native vessel intervention, even after adjustment for baseline characteristics. These complications are predominantly the result of embolization from the large and friable plaques present in vein grafts, leading to abrupt vessel closure. The resulting myocardial damage may lead to increased mortality. In order to prevent these complications, contemporary practice includes the utilization of emboli protection devices and adjunctive pharmacology designed to reduce the risk of embolization and minimize its consequences.