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Saphenous Vein Graft Interventions

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PanVascular Medicine

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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.

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Abbreviations

ACC/AHA:

American College of Cardiology/American Heart Association

AMEthyst:

Assessment of the Medtronic AVE Interceptor Saphenous Vein Graft Filter System

AWESOME:

The Angina With Extremely Serious Operative Mortality Evaluation Trial

BMS:

Bare-metal stent

CABG:

Coronary artery bypass grafting

DES:

Drug-eluting stent

EPD:

Emboli protection device

MACE:

Major adverse cardiac events

MI:

Myocardial infarction

PCI:

Percutaneous coronary intervention

RCT:

Randomized clinical trial

SVG:

Saphenous vein graft

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Authors and Affiliations

  1. Division of Cardiology, New York Methodist Hospital, 506 6th street, KP-2, Brooklyn, NY, 11215, USA

    Dr. Bilal Sarwar M.D. & Prof. Sorin J. Brener M.D. (Professor of medicine, Director)

Authors
  1. Dr. Bilal Sarwar M.D.
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  2. Prof. Sorin J. Brener M.D.
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Correspondence to Sorin J. Brener M.D. .

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Editors and Affiliations

  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Sarwar, B., Brener, S.J. (2014). Saphenous Vein Graft Interventions. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_76-1

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  • DOI: https://doi.org/10.1007/978-3-642-37393-0_76-1

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