What is the Optimal Management for Preventing Saphenous Vein Graft Diseases? Early Results of Intravascular Angioscopic Assessment

Mitsumasa Hata; Akira Sezai; Tetsuya Niino; Masataka Yoda; Shinji Wakui; Masaaki Chiku; Tadateru Takayama; Junko Honye; Satoshi Saitoh; Kazutomo Minami

doi:10.1253/circj.71.286

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What is the Optimal Management for Preventing Saphenous Vein Graft Diseases?

Early Results of Intravascular Angioscopic Assessment

Mitsumasa Hata, Akira Sezai, Tetsuya Niino, Masataka Yoda, Shinji Wakui, Masaaki Chiku, Tadateru Takayama, Junko Honye, Satoshi Saitoh, Kazutomo Minami

Author information

Mitsumasa Hata
Department of Cardiovascular Surgery, Nihon University School of Medicine
Akira Sezai
Department of Cardiovascular Surgery, Nihon University School of Medicine
Tetsuya Niino
Department of Cardiovascular Surgery, Nihon University School of Medicine
Masataka Yoda
Department of Cardiovascular Surgery, Nihon University School of Medicine
Shinji Wakui
Department of Cardiovascular Surgery, Nihon University School of Medicine
Masaaki Chiku
Department of Cardiology, Nihon University School of Medicine
Tadateru Takayama
Department of Cardiology, Nihon University School of Medicine
Junko Honye
Department of Cardiology, Nihon University School of Medicine
Satoshi Saitoh
Department of Cardiology, Nihon University School of Medicine
Kazutomo Minami
Department of Cardiovascular Surgery, Nihon University School of Medicine

Keywords: Anticoagulant therapy, Intra-coronary angioscopy, Saphenous vein graft

JOURNAL FREE ACCESS

2007 Volume 71 Issue 2 Pages 286-287

DOI https://doi.org/10.1253/circj.71.286

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Abstract

Background The predominant mechanism of early failure of saphenous vein grafts (SVG) after coronary bypass remains unclear, so angioscopy was used to identify the morphological changes. Methods and Results Of the 31 SVGs assessed 15 had both yellow plaque and thrombi, whereas in the remaining 16 SVGs the intima was clear white. The serum low-density lipoprotein cholesterol level was significantly higher in the diseased SVG group. Eight patients of the normal SVG group were prescribed ticlopidine, compared with only 1 from the diseased SVG group (p=0.015). Conclusions This is the first direct demonstration of yellow plaque and/or thrombosis in SVGs by intravascular angioscopy. In addition to the importance of prescribing statins, it might be vital to also add ticlopidine to aspirin therapy. (Circ J 2007; 71: 286 - 287)

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