Embolic protection devices in saphenous vein graft interventions

Saphenous vein grafts (SVGs) are widely used as aortocoronary conduits during coronary artery bypass surgery and are critical in the high early success of coronary bypass revascularization. Saphenous vein grafts tend to be more prone than native coronary arteries to accelerated atherosclerosis and intimal fibrosis and thus frequently lead to recurrent symptoms and require further revascularization. Percutaneous coronary interventions (PCI) have become the prime means of SVG mechanical revascularization but are plagued by higher complication rates than PCI on native coronaries, largely due to embolic debris mobilized from around the target lesion in the SVG. Several mechanical devices and techniques have been developed to capture this friable material during the PCI before it can embolize; these devices have shown great promise in reducing the morbidity and mortality of these interventions and should be employed routinely.