Conflict of interest: K. Marmagkiolis has no disclosures. Luc Bilodeau is a member of BSCI (Boston Scientific) advisory board and C. Grines is a member of Abbott Vascular advisory board.
Coronary Artery Disease
Current percutaneous treatment strategies for saphenous vein graft disease
Article first published online: 5 JUN 2013
Copyright © 2013 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 82, Issue 3, pages 406–413, 1 September 2013
How to Cite
Marmagkiolis, K., Grines, C. and Bilodeau, L. (2013), Current percutaneous treatment strategies for saphenous vein graft disease. Cathet. Cardiovasc. Intervent., 82: 406–413. doi: 10.1002/ccd.24554
- Issue published online: 26 AUG 2013
- Article first published online: 5 JUN 2013
- Accepted manuscript online: 6 JUL 2012 12:18PM EST
- Manuscript Accepted: 30 JUN 2012
- Manuscript Received: 23 FEB 2012
- saphenous vein grafts;
- embolic protection device;
- drug-eluting stents
Coronary artery bypass graft surgery remains one of the most widely performed surgical procedures in North America and aortocoronary saphenous vein grafts (SVG) are the most frequently used surgical conduits. SVG disease (SVGD) remains the leading cause of symptomatic coronary artery disease postcoronary artery bypass graft. When optimal medical therapy is ineffective, repeat surgery is associated with higher mortality combined with less favorable clinical and angiographic results, thus percutaneous revascularization on SVG is currently the standard of care for the revascularization of SVGD. Balloon angioplasty, bare metal stents, polytetrafluoroethylene-covered stents, and drug-eluting stents have been extensively investigated for SVG interventions. Multiple recent randomized trials and meta-analyses have confirmed the pathophysiologic and clinical differences between SVGD and coronary artery disease. Decisions such as patient selection, premedication, stent, and protection device characteristics should be carefully considered to achieve optimal procedural and clinical results. Acute coronary syndromes due to SVG involvement, chronic total occlusions, retrograde approaches, and SVG perforation management are newer fields requesting additional research. © 2013 Wiley Periodicals, Inc.