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Coronary artery bypass graft surgery: Prevention and management of vein graft stenosis

Thomas Levin, MD
Donald Cutlip, MD
Section Editor
Stephan Windecker, MD
Deputy Editor
Gordon M Saperia, MD, FACC


Most patients who undergo coronary artery bypass graft (CABG) surgery receive at least one saphenous vein graft (SVG) in addition to one or more arterial grafts. Compared to arterial grafts, vein grafts have a relatively high rate of clinically important stenosis at 5 and 10 years (movie 1). (See "Coronary artery bypass graft surgery: Causes and rates of graft failure", section on 'Vein grafts'.)

This topic will discuss issues related to the prevention, clinical presentation, and management of SVG stenosis. The risk factors for and rates of graft failure and long-term outcomes after CABG are discussed separately. (See "Coronary artery bypass graft surgery: Causes and rates of graft failure" and "Late recurrent angina pectoris after coronary artery bypass graft surgery" and "Coronary artery bypass graft surgery: Long-term clinical outcomes".)


Vein graft stenosis implies there is still flow in the graft and that revascularization is technically possible.

The phrase “vein graft occlusion” implies the graft is 100 percent closed (occluded). Ordinarily, this means there is no option for percutaneous revascularization of the graft itself, particularly if the occlusion is chronic.

When grafts are occluded, the best treatment is often to go after the native coronary vessel rather than try to recanalize an occluded graft. (See 'Indications for repeat revascularization' below.)

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Literature review current through: Nov 2017. | This topic last updated: Sep 05, 2017.
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