Key result
Drug-eluting stents and embolic protection devices are recommended during saphenous vein graft interventions to minimize complications such as periprocedural myocardial infarction and no-reflow.
Current evidence and guidelines support the use of drug-eluting stents and embolic protection devices to minimize complications during saphenous vein graft interventions.
Reinforces guideline-supported SVG PCI strategy; leaves open need for contemporary randomized validation.
Saphenous vein grafts (SVGs), used during coronary artery bypass graft surgery for severe coronary artery disease, are prone to degeneration and occlusion, leading to poor long-term patency compared with arterial grafts. Interventions used to treat SVG disease are susceptible to high rates of periprocedural MI and no-reflow. To minimise complications seen with these interventions, proper stents, embolic protection devices (EPDs) and pharmacological selection are crucial. Regarding stent selection, evidence has demonstrated superiority of drug-eluting stents over bare-metal stents in SVG intervention. The ACCF/AHA/SCA American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Society for Cardiovascular Angiography and Interventions guidelines recommend the use of EPDs during SVG intervention to decrease the risk of periprocedural MI, distal embolisation and no-reflow. The optimal pharmacological treatment for slow or no-reflow remains unclear, but various vasodilators show promise.
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Lee et al. (2017) conducted a review in Severe coronary artery disease with saphenous vein graft disease. Saphenous vein graft interventions was evaluated. Drug-eluting stents and embolic protection devices are recommended during saphenous vein graft interventions to minimize complications such as periprocedural myocardial infarction and no-reflow.
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