Related Experiment Video
Updated: Jul 5, 2026
Establishment and Evaluation of a Porcine Vein Graft Disease Model
Published on: July 25, 2022
DES implantation in saphenous vein and left internal mammary grafts
P Presbitero1, D Zavalloni, P Pagnotta
1Operative Unit of Invasive Cardiology, Humanitas Clinical Institute, IRCCS, Rozzano, Milan, Italy. patrizia.presbitero@humanitas.it
Insights
Drug-eluting stents (DES) show promise in treating saphenous graft disease after coronary artery bypass grafting (CABG), reducing restenosis. However, their benefit in arterial graft disease remains unclear, necessitating further research.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Background:
- Coronary artery bypass grafting (CABG) patients often require revascularization within 10 years, primarily due to saphenous graft disease.
- Consensus on the use of drug-eluting stents (DES) for saphenous and arterial graft disease is still lacking.
- Understanding the efficacy and safety of DES in treating bypass graft disease is crucial for patient management.
Purpose of the Study:
- To critically review the current literature on the treatment of saphenous and arterial graft disease using DES.
- To examine the positive and negative aspects of DES utilization in bypass graft interventions.
- To identify remaining questions and the need for further randomized trials regarding DES efficacy in this context.
Main Methods:
- Critical review of available scientific literature.
- Analysis of data concerning percutaneous revascularization with DES in saphenous and arterial grafts.
- Evaluation of clinical outcomes, including restenosis, target lesion revascularization (TLR), and stent thrombosis.
Main Results:
- Percutaneous revascularization with DES is feasible and safe for bypass graft disease, particularly in saphenous grafts.
- DES demonstrate antiproliferative effects, reducing in-stent restenosis and TLR rates in saphenous grafts.
- DES use is not associated with increased stent thrombosis; recurrence rates appear limited in cases of reintervention. However, data on arterial grafts, especially anastomotic disease, are scarce, showing no clear advantage of DES over bare-metal stents (BMS).
Conclusions:
- DES show potential benefits in managing saphenous graft disease by reducing restenosis and TLR.
- The efficacy of DES in arterial bypass graft disease remains uncertain, with limited data and no proven advantage over BMS.
- Further randomized trials are essential to establish definitive conclusions on DES efficacy for bypass graft lesions.
Abstract:
Forty percent of patients treated with CABG need further revascularizations after 10 years mainly due to saphenous--more than arterial--graft disease. In this issue, the Authors make a critical review of current available literature on the treatment of saphenous and arterial graft disease, a subset of lesions for which a clear consensus for DES use is still lacking. The Authors examine both the positive and negative aspects of DES use in this setting. Percutaneous revascularizations with DES are feasible and safe. The antiproliferative properties of DES seem to be effective even in the treatment of bypass disease, in particular in saphenous grafts. The clinical efficacy of a treatment with DES is expressed mainly in the reduction of in-stent restenosis and, therefore, in the rates of target lesion revascularization (TLR). Moreover, the use of DES is not associated to higher rates of stent thrombosis and, in case of reintervention, recurrence rates seem to be limited. However, the benefit provided by DES in prevention of restenosis may be limited by the progression of the disease in other segments than those treated with stents. Percutaneous treatment of arterial bypass with DES is feasible and safe. Most of available data on DES are on anastomotic disease (data on bypass ostium and shaft are too scarce to draw any conclusion). In this case, where the use of stents is imperative, there is no evidence of advantages gained by the use of DES over BMS in terms of new revascularizations. Some unanswered questions on DES use in this setting still remain. For this reason new randomized trials are required to definitively give a reliable answer on DES efficacy in this subset of lesions.
More Related Videos
05:37Human Internal Mammary Artery (IMA) Transplantation and Stenting: A Human Model to Study the Development of In-Stent Restenosis
Published on: May 9, 2012
09:09A Modified Heterotopic Swine Hind Limb Transplant Model for Translational Vascularized Composite Allotransplantation (VCA) Research
Published on: October 14, 2013