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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

Saphenous vein graft disease

S Peykar1, D J Angiolillo, T A Bass

  • 1Division of Cardiology and Cardiovascular Imaging Core, Laboratories University of Florida, Shands Jacksonville, Jacksonville, FL 32209, USA.

Minerva Cardioangiologica
|October 30, 2004
PubMed

Insights

Saphenous vein graft disease complicates coronary artery bypass grafting surgery. This review covers its causes, complications, and current therapeutic options, including promising new drug-eluting stents.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Saphenous vein graft (SVG) disease remains a significant challenge after coronary artery bypass grafting (CABG).
  • SVG disease progresses through distinct phases: thrombosis, intimal hyperplasia, and atherosclerosis, leading to recurrent ischemia.
  • Repeat operations carry high mortality/morbidity, while percutaneous treatments face procedural and long-term complications.

Purpose of the Study:

  • To review the pathogenesis of SVG disease.
  • To discuss current and emerging therapeutic options for managing SVG disease.
  • To highlight challenges and potential solutions in treating SVG disease.

Main Methods:

  • Literature review of pathogenesis and therapeutic strategies for SVG disease.
  • Analysis of complications associated with repeat operations and percutaneous interventions.
  • Evaluation of novel approaches, including drug-eluting stents and distal protection devices.

Main Results:

  • SVG disease involves thrombosis, intimal hyperplasia, and atherosclerosis, resulting in poor long-term patency.
  • Percutaneous treatment is hindered by distal embolization, no-reflow, myocardial infarction, and restenosis.
  • Distal protection devices offer some benefit; drug-eluting stents show promise for reducing restenosis.

Conclusions:

  • Effective management of SVG disease requires addressing its complex pathogenesis and multifactorial complications.
  • Novel therapies like drug-eluting stents represent a significant advancement in improving outcomes for SVG disease.
  • Further research is needed to optimize treatment strategies and improve long-term graft patency.

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