ABSTRACT
Options for revascularization in cases of saphenous vein graft (SVG) disease include either percutaneous coronary interventions (PCI) or repeat coronary artery bypass graft surgery (CABG). Due to a significantly higher risk of performing a repeat CABG, PCI is the preferred method of treating patients with SVG lesions. Especially in the presence of advanced age and comorbidities such as cerebrovascular, renal, malignancy, or pulmonary disease, the outcome of a second surgical approach is limited. In addition, re-CABG carries the potential for jeopardizing patent bypass vessels, and it is associated with less complete revascularization and control of symptoms when compared to the first procedure. Percutaneous revascularization of bypass grafts or native vessels is, therefore, the preferred treatment option for recurrent ischemia in CABG patients-particularly surgical high-risk candidates-associated with a high procedural success (97%) and an acceptable in-hospital major adverse cardiac event (MACE) rate (6-11%) (1). Furthermore, percutaneous intervention is standard in patients with degenerated grafts who still have patent arterial grafts, or patients with no suitable arterial or venous grafts for re-operation.
