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Updated: May 12, 2026

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 failure after coronary artery bypass surgery: pathophysiology, management, and future directions

Ralf E Harskamp1, Renato D Lopes, Clinton E Baisden

  • 1Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA.

Annals of Surgery
|April 12, 2013
PubMed

Insights

Vein graft failure (VGF) after coronary artery bypass graft surgery is a significant problem. New preventive strategies are promising but require further research and a focus on multidisciplinary prevention.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Biology
  • Biomedical Engineering

Background:

  • Vein graft failure (VGF) and native coronary artery disease progression limit the long-term success of coronary artery bypass graft (CABG) surgery.
  • Understanding the mechanisms of VGF is crucial for improving patient outcomes.

Purpose of the Study:

  • To review the current understanding of vein graft failure (VGF) epidemiology and pathogenesis.
  • To provide an overview of existing preventive and interventional measures for VGF.
  • To explore novel strategies aimed at enhancing vein graft patency.

Main Methods:

  • Comprehensive literature review of MEDLINE, EMBASE, and Cochrane databases (1966-2012).
  • Inclusion of basic science and clinical studies; exclusion of non-English publications.
  • Cross-referencing of selected articles to identify additional relevant studies.

Main Results:

  • Key mechanisms of VGF include acute thrombosis, neointimal hyperplasia, and accelerated atherosclerosis.
  • Preventive measures encompass conduit-vessel matching, lipid-lowering drugs, antithrombotic therapy, and smoking cessation.
  • Interventions for VGF involve medical therapy, percutaneous intervention, and repeat CABG surgery, with drug-eluting stents and embolic protection devices showing promise.

Conclusions:

  • VGF remains a primary cause of suboptimal in-hospital and long-term outcomes post-CABG surgery.
  • Emerging VGF prevention strategies like gene therapy and engineered grafts show potential but require validation.
  • Reducing VGF necessitates a multidisciplinary approach emphasizing prevention.
Abstract

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