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Updated: Aug 10, 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

Antithrombotic therapy in patients with saphenous vein and internal mammary artery bypass grafts

P D Stein1, J E Dalen, S Goldman

  • 1Henry Ford Health System, Cardiac Wellness Center, Detroit, MI 48202-3006, USA. pstein1@hfhs.org

Chest
|November 20, 1998
PubMed

Insights

Aspirin effectively reduces saphenous vein bypass graft occlusion for one year when initiated perioperatively. However, extended aspirin use beyond one year offers no additional graft patency benefits.

Area of Science:

  • Cardiovascular Surgery
  • Pharmacology
  • Thrombosis Research

Background:

  • Saphenous vein graft (SVG) occlusion is a significant complication after coronary artery bypass grafting (CABG).
  • Preventing SVG occlusion is crucial for long-term graft patency and patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of aspirin and other antithrombotic agents in preventing saphenous vein bypass graft occlusion.
  • To assess the impact of timing and duration of aspirin therapy on graft patency and bleeding complications.

Main Methods:

  • Systematic review and analysis of clinical trials investigating antithrombotic agents for SVG patency.
  • Comparison of aspirin (various doses and timings), aspirin plus dipyridamole, ticlopidine, and oral anticoagulants against placebo or control groups.

Main Results:

  • Aspirin (325-900 mg/d) initiated preoperatively or on the day of surgery effectively reduced SVG occlusion for one year.
  • Aspirin combined with dipyridamole showed no added benefit over aspirin alone.
  • Increased bleeding risk was observed with aspirin initiation one day before surgery.
  • Ticlopidine demonstrated efficacy in maintaining graft patency when started postoperatively.
  • Oral anticoagulants yielded inconsistent results for SVG patency maintenance.
  • Extended aspirin use beyond one year did not provide additional long-term graft patency benefits.

Conclusions:

  • Perioperative aspirin initiation is effective in reducing short-term saphenous vein bypass graft occlusion.
  • Long-term aspirin therapy beyond one year does not enhance graft patency.
  • Bleeding risk should be considered when timing aspirin initiation.
  • Ticlopidine may be an alternative for maintaining graft patency, while oral anticoagulants show limited efficacy.

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