Abstract
When used as conduits for coronary artery bypass surgery, saphenous vein grafts (SVG) develop atherosclerotic disease that may result in stenosis or occlusion in 50% of patients by 10 years. SVG intervention has become an attractive alternative to reoperation in these patients, but is associated with less favourable acute and long-term outcomes compared with percutaneous coronary intervention (PCI) of native vessels due to a higher incidence of periprocedural micro-embolisation and of late restenosis. The role of protection devices that reduce distal embolisation and no-reflow phenomenon has been well established, and they now represent a ‘must’ for almost all of the procedures of PCI in SVG. The potential role of drug-eluting stents (DES) in improving long-term results of SVG intervention is still debated and, to date, there is no clear evidence of their benefit in relevant clinical end-point. The aim of this article is to examine the best available therapeutic options for patients undergoing PCI of SVG lesions.
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