Percutaneous Coronary Intervention of Saphenous Vein Graft Failure

The percutaneous treatment of patients with obstructive atherosclerotic disease in coronary saphenous vein bypass grafts remains a challenge in interventional cardiology. Several disadvantages after percutaneous treatment of saphenous vein grafts are evident when compared to the treatment of native vessels: a high incidence of acute complications, specifically distal embolization and a higher rate of peri-procedural myocardial infarctions; an increased incidence of restenosis (even after stenting) and of repeated revascularizations; and a faster progression of moderate “non-significant” lesions in the same or in other grafts left untreated during the first intervention. The actual evidence-based knowledge recommends drug-eluting stents and embolic protection devices as the treatment of choice for the percutaneous management of this lesion subset.