Key result
Review outlines saphenous vein graft failure pathogenesis and summarizes contemporary prevention and treatment options.
Why the study?
Do medical and surgical interventions prevent saphenous vein graft failure in patients undergoing CABG?
Do medical and surgical interventions prevent saphenous vein graft failure in patients undergoing CABG?
Optimal surgical techniques and aggressive medical therapies, including antiplatelets and statins, are essential to mitigate the high rates of saphenous vein graft failure following CABG.
Highlights SVG failure mechanisms and options; extends synthesis but leaves open optimal strategies pending RCTs.
Coronary artery bypass grafting (CABG) remains a vital treatment for patients with multivessel coronary artery disease (CAD), especially diabetics. The long-term benefit of the internal thoracic artery graft is well established and remains the gold standard for revascularization of severe CAD. It is not always possible to achieve complete revascularization through arterial grafts, necessitating the use of saphenous vein grafts (SVG). Unfortunately, SVGs do not have the same longevity, and their failure is associated with significant adverse cardiac outcomes and mortality. This paper reviews the pathogenesis of SVG failure, highlighting the difference between early, intermediate, and late failure. It also addresses the different surgical techniques that affect the incidence of SVG failure, as well as the medical and percutaneous prevention and treatment options in contemporary practice.
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McKavanagh et al. (2017) conducted a review in Saphenous vein graft failure in multivessel coronary artery disease. Management and prevention strategies (surgical, medical, percutaneous) was evaluated. This review outlines the pathogenesis of early, intermediate, and late saphenous vein graft failure and summarizes contemporary surgical, medical, and percutaneous prevention and treatment options.
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