ABSTRACT
SVG disease after CABG is common. One year after surgery, up to 15% of SVG are occluded and only 61% of SVG are patent at 10 years. Among the patent SVG, many are diffusely diseased and repeat CABG is associated with increased morbidity and mortality. Therefore, PCI is the preferred revascularization strategy for SVG disease. However, it is limited by a substantial risk of MACE caused mainly by periprocedural MI as a result of no-reflow and distal embolization. Treatment of SVG disease is associated with a high rate of restenosis ranging from 20% to 37% and high rates of TVR. Recent advances in SVG PCI have included the development of EPDs that have reduced the rates of 30-day MACE by 42%. Nonetheless, SVG PCI is still associated with worse long-term outcomes than native coronary artery PCI and research is needed to develop pharmacologic as well as mechanical devices to improve the outcomes of SVG PCI.
