Saphenous vein graft intervention

Michael S. Lee, Seung Jung Park, David E. Kandzari, Ajay J. Kirtane, William F. Fearon, Emmanouil S. Brilakis, Paul Vermeersch, Young Hak Kim, Ron Waksman, Julinda Mehilli, Laura Mauri, Gregg W. Stone

Research output: Contribution to journalReview articlepeer-review

94 Scopus citations

Abstract

Saphenous vein grafts are commonly used conduits for surgical revascularization of coronary arteries but are associated with poor long-term patency rates. Percutaneous revascularization of saphenous vein grafts is associated with worse clinical outcomes including higher rates of in-stent restenosis, target vessel revascularization, myocardial infarction, and death compared with percutaneous coronary intervention of native coronary arteries. Use of embolic protection devices is a Class I indication according to the American College of Cardiology/American Heart Association guidelines to decrease the risk of distal embolization, no-reflow, and periprocedural myocardial infarction. Nonetheless, these devices are underused in clinical practice. Various pharmacological agents are available that may also reduce the risk of or mitigate the consequences of no-reflow. Covered stents do not decrease the rates of periprocedural myocardial infarction and restenosis. Most available evidence supports treatment with drug-eluting stents in this high-risk lesion subset to reduce angiographic and clinical restenosis, although large, randomized trials comparing drug-eluting stents and bare-metal stents are needed.

Original languageEnglish (US)
Pages (from-to)831-843
Number of pages13
JournalJACC: Cardiovascular Interventions
Volume4
Issue number8
DOIs
StatePublished - Aug 2011

Keywords

  • percutaneous coronary intervention
  • saphenous vein graft
  • stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Saphenous vein graft intervention'. Together they form a unique fingerprint.

Cite this