PCI in Saphenous Vein Grafts: Difference between revisions
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Coronary artery revascularization with [[saphenous veins]] ([[saphenous vein grafts]] or [[SVGs]]) has become a modern surgical standard for the treatment of [[coronary artery disease]]. This technique can be employed when a native [[coronary artery]] is blocked, thus causing a reduction or obstruction in [[blood flow]]. [[Cardiac surgeons]] use the sutured graft to connect the [[aorta]] to the coronary artery beyond the area of obstruction, so that [[blood flow]] may resume. | Coronary artery revascularization with [[saphenous veins]] ([[saphenous vein grafts]] or [[SVGs]]) has become a modern surgical standard for the treatment of [[coronary artery disease]]. This technique can be employed when a native [[coronary artery]] is blocked, thus causing a reduction or obstruction in [[blood flow]]. [[Cardiac surgeons]] use the sutured graft to connect the [[aorta]] to the coronary artery beyond the area of obstruction, so that [[blood flow]] may resume. | ||
Despite their ability to restore [[blood flow]], SVGs commonly encounter [[stenosis]] problems. The incidence of SVG stenosis is 15-30% one year after surgery, and it increases to 50% 10 years after surgery. Several factors contribute to [[stenosis]] of [[saphenous vein grafts]], including [[intimal hyperplasia]], [[plaque]] formation, and graft remodeling. Additionally, arterialization of the graft accelerates [[atherosclerosis]]. | Despite their ability to restore [[blood flow]], SVGs commonly encounter [[stenosis]] problems. The incidence of SVG stenosis is 15-30% one year after surgery, and it increases to 50% 10 years after surgery. Several factors contribute to [[stenosis]] of [[saphenous vein grafts]], including [[intimal hyperplasia]], [[plaque]] formation, and graft remodeling. Additionally, arterialization of the graft accelerates [[atherosclerosis]]. Furthermore, [[atheroma]] found in SVGs are more friable (easily break into small pieces) and more prone to [[thrombus]] than [[plaques]] found in native vessels. Another reason why SVGs are more susceptible to [[thrombotic occlusion]] is that they lack side branches. | ||
Although intervention on a chronic total occlusion of an SVG may seem like an effective treatment strategy, it is best avoided. | |||
{{SIB}} | {{SIB}} | ||
Revision as of 15:46, 18 May 2010
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Background
Coronary artery revascularization with saphenous veins (saphenous vein grafts or SVGs) has become a modern surgical standard for the treatment of coronary artery disease. This technique can be employed when a native coronary artery is blocked, thus causing a reduction or obstruction in blood flow. Cardiac surgeons use the sutured graft to connect the aorta to the coronary artery beyond the area of obstruction, so that blood flow may resume.
Despite their ability to restore blood flow, SVGs commonly encounter stenosis problems. The incidence of SVG stenosis is 15-30% one year after surgery, and it increases to 50% 10 years after surgery. Several factors contribute to stenosis of saphenous vein grafts, including intimal hyperplasia, plaque formation, and graft remodeling. Additionally, arterialization of the graft accelerates atherosclerosis. Furthermore, atheroma found in SVGs are more friable (easily break into small pieces) and more prone to thrombus than plaques found in native vessels. Another reason why SVGs are more susceptible to thrombotic occlusion is that they lack side branches.
Although intervention on a chronic total occlusion of an SVG may seem like an effective treatment strategy, it is best avoided.