In medicine, vein graft failure (VGF) is a condition in which vein grafts, which are used as alternative conduits in bypass surgeries (e.g. CABG), get occluded.
Veins, mainly the great saphenous vein (GSV) are the most frequently used conduits in bypass surgeries (CABG or PABG), due to their ease of use and availability.[1] Some structural changes of intima thickening and vein wall remodeling are necessary for vein graft adaptation to the arterial environment. The reasons why some of the grafts progress to clinical stenosis is unknown. The patency rates of saphenous vein grafts after CABG at 1 year is approximately 80%.[2][3] After 5 years the patency rate drops to 65% and at 10 years GSV patency rates are approximately 50%, with only half of the veins are atherosclerosis free.[4] VGF may be identified in asymptomatic patients, but can also produce symptoms of ischemia, depending on the area of the supplied territory of the heart, and the function of native arteries and other grafts. VGF has been closely correlated with revascularization, myocardial infarction and death.[2][5] Treatment of occluded GSVs can be performed by percutaneous coronary intervention or redo CABG and is considered to be challenging, and thus preventing their obstruction is of great importance.[6]
^Goldman S, Zadina K, Moritz T, Ovitt T, Sethi G, Copeland JG, Thottapurathu L, Krasnicka B, Ellis N, Anderson RJ, Henderson W (December 2004). "Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study". J. Am. Coll. Cardiol. 44 (11): 2149–56. doi:10.1016/j.jacc.2004.08.064. PMID 15582312.
^ abFitzgibbon, GM; Kafka, HP; Leach, AJ; Keon, WJ; Hooper, GD; Burton, JR (September 1996). "Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years". Journal of the American College of Cardiology. 28 (3): 616–26. doi:10.1016/0735-1097(96)00206-9. PMID 8772748.
^McKavanagh P, Yanagawa B, Zawadowski G, Cheema A (December 2017). "Management and Prevention of Saphenous Vein Graft Failure: A Review". Cardiol Ther. 6 (2): 203–223. doi:10.1007/s40119-017-0094-6. PMC 5688971. PMID 28748523.
^Halabi AR, Alexander JH, Shaw LK, Lorenz TJ, Liao L, Kong DF, Milano CA, Harrington RA, Smith PK (November 2005). "Relation of early saphenous vein graft failure to outcomes following coronary artery bypass surgery". Am. J. Cardiol. 96 (9): 1254–9. doi:10.1016/j.amjcard.2005.06.067. PMID 16253593.
^Lichtenwalter C, de Lemos JA, Roesle M, Obel O, Holper EM, Haagen D, et al. (September 2009). "Clinical presentation and angiographic characteristics of saphenous vein graft failure after stenting: insights from the SOS (stenting of saphenous vein grafts) trial". JACC Cardiovasc Interv. 2 (9): 855–60. doi:10.1016/j.jcin.2009.06.014. PMID 19778774.
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