Saphenous vein graft intervention

JACC Cardiovasc Interv. 2011 Aug;4(8):831-43. doi: 10.1016/j.jcin.2011.05.014.


Saphenous vein grafts are commonly used conduits for surgical revascularization of coronary arteries but are associated with poor long-term patency rates. Percutaneous revascularization of saphenous vein grafts is associated with worse clinical outcomes including higher rates of in-stent restenosis, target vessel revascularization, myocardial infarction, and death compared with percutaneous coronary intervention of native coronary arteries. Use of embolic protection devices is a Class I indication according to the American College of Cardiology/American Heart Association guidelines to decrease the risk of distal embolization, no-reflow, and periprocedural myocardial infarction. Nonetheless, these devices are underused in clinical practice. Various pharmacological agents are available that may also reduce the risk of or mitigate the consequences of no-reflow. Covered stents do not decrease the rates of periprocedural myocardial infarction and restenosis. Most available evidence supports treatment with drug-eluting stents in this high-risk lesion subset to reduce angiographic and clinical restenosis, although large, randomized trials comparing drug-eluting stents and bare-metal stents are needed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary* / adverse effects
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Antithrombins / therapeutic use
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / surgery*
  • Coronary Restenosis / etiology
  • Coronary Restenosis / physiopathology
  • Coronary Restenosis / therapy*
  • Embolic Protection Devices
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors
  • Saphenous Vein / physiopathology
  • Saphenous Vein / transplantation*
  • Stents
  • Treatment Outcome
  • Vascular Patency


  • Antithrombins
  • Platelet Aggregation Inhibitors