Key result
Percutaneous revascularization may provide an alternative treatment for narrowed saphenous vein grafts.
Percutaneous interventions such as balloon angioplasty, stenting, and atherectomy provide a viable alternative to repeat bypass surgery for patients with significant narrowing in saphenous vein grafts.
May support percutaneous intervention as alternative to redo CABG for SVG stenoses; leaves open need for randomized trials.
Coronary artery bypass surgery often is used to treat patients who have multivessel coronary artery disease requiring revascularization. Unfortunately, within a decade of surgery, significant atherosclerosis may develop in the vein grafts of these patients, requiring additional revascularization. Repeat coronary artery bypass surgery is necessary in selected patients. However, the risk of mortality is increased when compared with the first operation and may not be feasible in some patients. Percutaneous revascularization may provide an alternative treatment for patients who are not candidates for repeat surgery and for those who choose not to undergo repeat bypass surgery. Significant narrowings in saphenous vein conduits can be treated with careful use of balloon angioplasty and newer percutaneous techniques, such as stenting and atherectomy (directional and extraction). Successful percutaneous intervention may result in significant clinical improvement for these patients.
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Khan et al. (1995) conducted a review in Significant atherosclerosis in saphenous vein aortocoronary conduits. Percutaneous revascularization (balloon angioplasty, stenting, and atherectomy) was evaluated. Percutaneous revascularization using balloon angioplasty, stenting, or atherectomy may provide an alternative treatment for patients with significant narrowings in saphenous vein conduits.
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