PCI in Saphenous Vein Grafts: Difference between revisions

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#redirect[[Saphenous Vein Graft]]
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'''Associate Editors-In-Chief:''' Jason C. Choi, M.D., Xin Yang, M.D.
 
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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.
 
==Goals of Treatment==
 
Primarily, the goal should be to detect and treat a SVG [[stenosis]] early in the development of [[ischemia]] while the SVG is still patent.  [[Patent (disambiguation)|Patency]] allows intervention to be performed before the SVG is completely [[occlusion|occluded]], at which point intervention can no longer be performed. 
 
 
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Latest revision as of 19:19, 10 August 2012