SVG interventions

Interventions on saphenous vein grafts (SVG) with restenosis are being increasingly done these days. If there is a thrombotic occlusion of a degenerated vein graft, the chance for major adverse coronary events (MACE) are higher after an intervention and results poor. Hence it is seldom an option in total thrombotic occlusion of a venous graft. Use of distal protection device is rather mandatory in SVG interventions as the chance of distal embolization is higher. It is better to use and undersized stent than an oversized stent for SVG intervention. Distal overhang of the stent is required to reduce distal embolization. It may be remembered that if there is an option for intervention in a native vessel in a post coronary artery bypass (CABG) situation, it should be preferred over an SVG intervention.