Home

Saphenous vein graft failure treatment

I am very happy for this varicose veins remedy. The last time I was so happy was maybe 10 years ago or so : Management and Prevention of Saphenous Vein Graft Failure: A Review Peter McKavanagh. Bobby Yanagawa. George Zawadowski. Asim Cheema Received: May 8, 2017/Published online: July 26, 2017 The Author(s) 2017. This article is an open access publication ABSTRACT Coronary artery bypass grafting (CABG) remains a vital treatment for patients with. Testa L, Agostoni P, Vermeersch P, et al. Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease: a systematic review and meta-analysis. EuroIntervention. 2010;6:527-36. PubMed Article Google Scholar 154 Use of oral anticoagulants has not been tested in treatment of thrombotic occlusion of saphenous vein graft (SVG) disease. Here we describe the use of the novel oral anticoagulant rivaroxaban in the treatment of occlusive SVG disease with intraluminal thrombus, leading to successful recanalization

Saphenous vein grafts remain the most widely used conduit during coronary artery bypass grafting, and the rates of vein graft failure (VGF) during the first 12 to 18 months after surgery have been reported to be as high as 25%. In this analysis from the Project of Ex Vivo Vein Graft Engineering via Transfection IV (PREVENT IV) trial, we. Aims: Treatment of saphenous vein graft (SVG) disease is still a matter of debate given the uncertainty of the available conflicting data. Our aim was to assess, by means of a meta-analytic.

Dental Implants Failure-Bone Graft Failur

  1. The great saphenous vein—the large vein running up the length of the leg—is often used as a bypass due to its size and the ease of removing a small segment. After grafting, implanted veins remodel to become more arterial. However, the remodeling can go awry and the vein can become too thick, resulting in clogged blood flow
  2. Approximately 50% of saphenous vein grafts (SVGs) fail by 5 to 10 years post-coronary artery bypass grafting (CABG) and between 20-40% fail within the first year (1, 2). While SVG failure can sometimes be silent, when symptomatic events occur, SVG percutaneous coronary intervention (PCI) is often performed
  3. In addition, saphenous vein grafts are often used for peripheral bypass surgeries particularly in the lower extremities. For example, a saphenous vein may be mobilized and utilized for a femoral to the popliteal artery for occluded vessels not amenable to conservative treatment or angioplasty
  4. To prevent vein graft occlusion, lifestyle management, antithrombotic therapies, and lipid-lowering therapies are key

Natural history of saphenous vein thrombosis. Historically saphenous vein thrombosis was regarded as a benign condition. It was a disease treated by surgeons and encountered mainly in immobilized post-surgical patients. However there is data to suggest otherwise. Modern data suggests that saphenous vein thrombosis can propagate Saphenous vein grafts (SVG) have been extensively used in coronary artery bypass surgery (CABG) as additional conduits to arterial grafts. However, it is well known that vein grafts may develop degenerative processes that may result in stenosis or occlusion 1 in 12-20% of patients at the end of the first year and approximately 50% by 10 years. 2 The main causes of graft disease are intimal. Saphenous vein graft patency rates 1 year post-CABG were 88.7% (432 of 487 vein grafts) with ticagrelor + aspirin; 82.8% (404 of 488 vein grafts) with ticagrelor alone; and 76.5% (371 of 485 vein. Most patients who undergo coronary artery bypass graft (CABG) surgery receive at least one saphenous vein graft (SVG) in addition to one or more arterial grafts. Compared to arterial grafts, vein grafts have a relatively high rate of clinically important stenosis at 5 and 10 years (movie 1) Saphenous vein graft (SVG) disease has been an obstinate problem facing the cardiologist since the early days of coronary artery bypass grafting (CABG) surgery. SVG disease follows temporally distinct phases of thrombosis, intimal hyperplasia and progressive atherosclerosis leading to recurrent isch

Varicose Veins Treatment - This Remedy Changed My Lif

Coronary artery revascularization with saphenous vein grafts (SVGs) has become a surgical standard for treatment of coronary artery disease since Favaloro first described it in 1967. Riahi and associates described the rare complication of saphenous vein graft aneurysm (SVGA) in 1975 Once graft failure occurs, the available treatments are either surgical reintervention, angioplasty, or conservative medical management reserved for patients not eligible for either procedure

Patients with saphenous vein graft (SVG) disease represent an increasing proportion of those referred for percutaneous coronary intervention. The success of treatment of occluded SVG with percutaneous intervention has been limited by frequent occurrence of no-reflow phenomenon. Use of self-expanding stents with low pressure pre- and post. Nitric oxide donating aspirins: novel drugs for the treatment of saphenous vein graft failure. Shukla N (1), Angelini GD, Ascione R, Talpahewa S, Capoun R, Jeremy JY Saphenous vein grafts are imperfect yet indispensable conduits commonly used for coronary artery bypass grafting.Their degeneration ultimately leading to occlusion results from the pathological response of the vein to altered blood rheology and several types of vascular injury.Surgical techniques minimizing vessel damage, and prolonged antiplatelet and lipid-lowering treatment are established.

Saphenous vein grafts are imperfect yet indispensable conduits commonly used for coronary artery bypass grafting. Their degeneration ultimately leading to occlusion results from the pathological response of the vein to altered blood rheology and several types of vascular injury Aspirin is considered the preferred antiplatelet drug to prevent saphenous vein graft failure after coronary artery bypass graft (class I, level of evidence A). 18 Updated meta-analyses support this recommendation, but at a cost of increasing the risk of bleeding. 19 20 21 Uncertainty remains about the benefits of adding a P2Y12 inhibitor or oral anticoagulant to aspirin monotherapy The first aortocoronary saphenous vein graft implantation in a human being by Garrett and colleagues in May 1967 1 and the subsequent pioneering work of Favaloro 2 ushered in the era of surgical revascularization for the global epidemic of ischemic heart disease. This major advance in surgical practice afforded an effective treatment for intractable angina and also a means of markedly.

In medicine, vein graft failure (VGF) is a condition in which vein grafts, which are used as alternative conduits in bypass surgeries (e.g. CABG), get occluded. Veins, mainly the great saphenous vein (GSV) are the most frequently used conduits in bypass surgeries (CABG or PABG), due to their ease of use and availability Treatment of saphenous vein graft disease is an emerging problem, due to the increasing number of patients undergoing bypass surgery. Stent implantation has better long-term outcome compared to balloon angioplasty. 40 In a preliminary study,.

  1. Saphenous vein graft (SVG) disease after coronary artery bypass grafting (CABG) occurs in three phases: thrombosis, intimal hyperplasia, and atherosclerosis. Within the first month, thrombosis plays a major role. From month 1 to month 12, intimal hyperplasia occurs. Beyond 12 months, atherosclerosis becomes the primary cause for late graft failure
  2. Saphenous vein graft disease (SVGD) is a type of vascular disease that may develop after coronary artery bypass grafting (CABG). SVGD seriously affects the short-term and long-term effects of CABG and increases the incidence of major adverse cardiovascular events
  3. Once graft failure occurs, the available treatments are either surgical reintervention, angioplasty, or conservative medical management reserved for patients not eligible for either procedure.CONCLUSION: Despite the extensive amount of research performed, the pathophysiology of saphenous vein graft is still not completely understood
  4. During leg bypass surgery, you will receive general or spinal anesthesia so you do not feel any pain. Your surgeon prepares a graft by removing a healthy vein, usually the greater saphenous vein (that runs from the groin to the foot) from your own body, or by using a prosthetic graft (if no suitable vein is available )
  5. Once graft failure occurs, the available treatments are either surgical reintervention, angioplasty, or conservative medical management reserved for patients not eligible for either procedure. Despite the extensive amount of research performed, the pathophysiology of saphenous vein graft is still not completely understood
Hitesh @ RUMS:UCL

Management and Prevention of Saphenous Vein Graft Failure

Experienced dental negligence in the last 3 years? Contact our specialists now. High quality legal representation exclusively for patients. Dedicated team. Enquire now 4. Saphenous vein graft failure Studies of saphenous veins harvested for bypass procedures have shown that many have abnormal histological and physical attributes. [23,24] Moreover, the quality of the saphenous vein can have significant clinical consequences. Therefore, vein grafts in the arterial circulatio Response to: Sayah N, Lefèvre G, Picard F. Drug eluting stents versus bare metal stents for the treatment of saphenous vein grafts failure: learnings from the DIVA trial. J Thorac Dis 2019;11:S399-403. Pellicano M, Azzano A, Barbato E. Second-generation drug-eluting stents versus bare-metal stents in saphenous vein grafts: is the choice mor 4. Saphenous vein graft failure. Studies of saphenous veins harvested for bypass procedures have shown that many have abnormal histological and physical attributes. [23,24] Moreover, the quality of the saphenous vein can have significant clinical consequences. Therefore, vein grafts in the arterial circulation must be considered as a viable. Saphenous vein graft disease treatment en Francais. Business Saphenous vein graft disease treatment in the Marketplace. Patents on Saphenous vein graft disease treatment. Experimental / Informatics List of terms related to Saphenous vein graft disease treatment. Editor-In-Chief: C. Michael Gibson, M.S., M.D

Saphenous vein graft failure after coronary artery bypass surgery: Pathophysiology, management, and future directions. Ralf E lipid-lowering drugs, antithrombotic therapy, and cessation of smoking. Treatment of VGF includes medical therapy, percutaneous intervention, and redo coronary artery bypass graft surgery. In patients undergoing. Compared with aspirin alone, aspirin and ticagrelor use was associated with a halving of the risk of saphenous vein graft vein failure (OR 0.50; 95% CI 0.31-0.79). Similarly, aspirin and clopidogrel use was associated with a 40% lower risk of graft failure compared with aspirin alone (OR 0.60; 95% CI 0.42-0.86)

Article. Shedding Light Into Late Saphenous Vein Graft Failure. January 2019; Cardiovascular Revascularization Medicine 20(1):6- Saphenous vein grafts (SVGs) are the most frequently used conduits for coronary artery bypass graft (CABG) surgery but are associated with 10-year vein graft failure (VGF) rates of 40−50% Introduction. Coronary artery bypass grafting (CABG) is the most widely used treatment modality for patients with ischemic heart disease worldwide. 1,2 Despite the increased emphasis given to the use of arterial grafts, the long saphenous continues to be the most commonly used conduit for CABG and remains the mainstay. In fact, majority of the patients complain of leg wound rather than sternal. Determinants of Sapheous Vein Graft Patency Saphenous vein graft failure as a Surrogate Endpoint in Clinical Trials Treatment 2011 ACCF/AHA/SCAI Guideline Recommendations Clinical Trials. Radial Artery Versus Saphenous Vein Grafts in Coronary Artery Bypass Surgery; The RETRIEVE Study: Use of the FiberNet Embolic Protection System in Saphenous.

Angelini GD, Jeremy JY: Towards the treatment of vein bypass graft failure - a perspective of the Bristol Heart Institute. Biorheology 2002, 39: 491-499. PubMed Google Scholar 5. Lie JT, Lawrie GM, Morris G: Aortocoronary bypass saphenous vein graft atherosclerosis. Am J Cardiol 1997, 40: 907-914. Google Schola Despite major advances in catheter-based therapy and adjunctive pharmacology, percutaneous revascularisation of diseased saphenous vein bypass grafts (SVGs) remains a critical challenge for the interventional cardiologist. Degeneration and occlusion of vein grafts is a common problem with an incidence of 15% to 30% in year one after surgery, 1% to 2% annual occlusion rates in years one to six. Coronary artery bypass graft surgery (CABG) is widely used for the treatment of atheromatous stenosis of coronary arteries. However, as many as 50% of grafts fail within 10 years after CABG due to neointima (NI) formation, a process involving the proliferation and migration of vascular smooth muscle cells (VSMCs). Superimposed on neointima formation is accelerated atherogenesis which. damage, or saphenous vein graft failure.3-7 Previous studies have shown rates of saphenous vein graft failure of up to 30-40% in the first year8 9 and up to 70% beyond 10 years after coronary artery bypass graft surgery.8 10-13 Despite its relatively high early failure rates, saphenous vein graft remains the mos T1 - Saphenous vein graft failure after coronary artery bypass surgery insights from PREVENT IV. AU - Hess, Connie N. AU - Lopes, Renato D. AU - Gibson, C. Michael. AU - Hager, Rebecca. AU - Wojdyla, Daniel M. AU - Englum, Brian R. AU - Mack, Michael J. AU - Califf, Robert M

Rivaroxaban for the treatment of saphenous vein graft

Saphenous vein grafts (SVGs) are commonly used during coronary artery bypass graft surgery (CABG) for severe coronary artery disease. However, SVGs are prone to both degeneration and occlusion, leading to poor long-term patency compared with arterial grafts Use of oral anticoagulants has not been tested in treatment of thrombotic occlusion of saphenous vein graft (SVG) disease. Here we describe the use of the novel oral anticoagulant rivaroxaban in the treatment of occlusive SVG disease with intraluminal thrombus, leading to successful recanalization The most common site for saphenous vein graft aneurysm (SVGA) formation appears to be the right coronary artery (38.0%), followed by the left anterior descending (25.3%), obtuse marginal (10.9%), and left circumflex (10.5%), according to a systematic review of published cases by Ramirez et al. [] True aneurysms develop in the body of the vein graft and are typically fusiform Saphenous-vein graft disease after coronary-artery bypass surgery results in a 40 percent rate of graft failure at 10 years. 1 Percutaneous treatment of saphenous-vein grafts is associated with. Turk Kardiyol Dern Ars. 2012; 40(8): 736-743 | DOI: 10.5543/tkda.2012.26790 Saphenous vein graft disease: causes, prevention, and contemporary treatment strategies Seher Gökay, Davran Çiçek Department of Cardiology, Baskent University School of Medicine, Antalya, Turke

Saphenous Vein Graft Failure After Coronary Artery Bypass

(PDF) Treatment of Saphenous Vein Graft Disease: Never

  1. The rate of the remodeling of the arterialized saphenous vein conduit limits the outcomes of coronary artery bypass graft surgery (CABG), which may be influenced by endothelial dysfunction
  2. Kretschmer GJ, Wenzl E, Wagner O, et al. Influence of anticoagulant treatment in preventing graft occlusion following saphenous vein bypass for femoropopliteal occlusive disease. Br J Surg 1986.
  3. Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions. Journal Article (Journal Article;Review) OBJECTIVE: To review our current understanding of the epidemiology and pathogenesis of vein graft failure (VGF), give an overview of current preventive and interventional measures, and.
  4. Saphenous vein, the currently most frequently used graft material, occupies over 70% of all graft vessels. Multiple factors may contribute to the early restenosis or occlusion of the vein grafts, including anastomosis technique, graft vessel quality, target lesion site and degree of stenosis, perioperative coagulating function, etc
  5. g the first intracranial bypass using a saphenous vein graft in 1971. 1 Despite an overall decrease in the use of intracranial SV bypasses due to an increased use of endovascular techniques for complex intracranial vascular.
  6. Development of a risk score for early saphenous vein graft failure: An individual patient data meta-analysis Alexios S. Antonopoulos,MD,PhD,a AyodeleOdutayo,MD, PhD,b Evangelos K. Oikonomou,MD,PhD,a Marialena Trivella, BSc, MSc, DPhil,b Mario Petrou, PhD, FRCS (CTh),c Gary S. Collins, BSc, PhD,b and Charalambos Antoniades, MD, PhD,a the SAFINOUS-CABG (Saphenous Vein Graft Failure—A
  7. Late graft stenosis, particularly of saphenous vein grafts due to atherosclerosis causing recurrent angina or myocardial infarction. Acute renal failure due to embolism or hypoperfusion. Stroke, secondary to embolism or hypoperfusion. Vasoplegic syndrome, secondary to cardiopulmonary bypass and hypothermi

Why Many Vein Grafts Fail National Institutes of Health

Video: Saphenous vein graft failure: seeing the bigger picture

Saphenous Vein Grafts - StatPearls - NCBI Bookshel

Correction of a saphenous vein graft to coronary vein anastamosis by selective retrograde coil-induced occlusion to arterialize the native vein. Differential effects of platelet-derived growth factor isotypes on human smooth muscle cell proliferation and migration are mediated by distinct signaling pathways In order to establish the anatomic criteria, the functional results, and the safety of complete myocardial revascularization for severe coronary artery disease, 100 consecutive patients who received four or five saphenous-vein grafts were analyzed. Ages ranged from 37 to 75 years (mean, 56 years). Men predominated by a ratio of 12:1. As an indication of the severity of multiple-vessel disease. Saphenous Vein Graft Infection. Infection and erosion of the saphenous vein graft with mediastinal hemorrhage is a rare but highly lethal complication of cardiac surgery. This is associated with a mortality rate of 50%. We present a patient who died during the postoperative period due to this complication We report a case of a 74-year-old man who presented with dyspnea on exertion and pedal edema. He had five-vessel coronary artery bypass graft (CABG) surgery twenty-six years ago and redo three-vessel CABG done thirteen years later. Computed tomographic angiography (CTA) of the heart and coronary vessels demonstrated a giant aneurysm arising from the saphenous venous graft (SVG) to the first.

Therapies to Improve Vein Graft Patency After CABG

Saphenous Vein Thrombosis Treatment - Angiologis

Vein-Graft Wrapping 753 Figure 2. The greater saphenous vein is wrapped around the me-dian nerve (case 1). procedure is completed by loosely tacking each section of the wrap around the nerve with 7-0 prolene sutures. Post-operatively, the wrist is immobilized for one week in slight extension to prevent prolapse (Fig. 7). Case Saphenous vein grafts with multiple versus single distal targets in patients undergoing coronary artery bypass surgery: one-year graft failure and five-year outcomes from the project of ex-vivo vein graft engineering via transfection (PREVENT) IV trial Bypass surgery using a large saphenous vein graft, or another autologous venous graft, is a well-recognised treatment option for managing peripheral arterial disease of the lower limb, including chronic limb-threatening ischaemia (CLTI) and intermittent claudication, peripheral limb aneurysms, and major limb arterial trauma Figure 2: Early graft failure in saphenous vein graft occluded by thrombus (t) in its lumen. (H&E; X12.5 magni cation). 2Early Changes in Saphenous Vein Grafts Changes in the saphenous vein begin at the time of harvesting, surgical preparation of the vessel and its transplantation into the arterial system. Studies o This suggests that the process of distention is an inciting event that allows for the upregulation of scavenger receptors, leading to graft failure through atherosclerotic lesion progression initiated by the formation of foam cells in these saphenous vein grafts. Pressure distention of saphenous vein conduits has been part of the standard vein.

Best Treatment of Saphenous Vein Graft Lesions ICR Journa

Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) poses a higher risk of distal embolization and no-reflow with attendant periprocedural myocardial infarction and in-hospital and long-term mortality. 1 In this Tip of the Month, we will discuss strategies to optimize outcomes of SVG PCI Femoro-popliteal bypass was performed in 38 cases (22.2%), whereas 133 (77.8%) of the bypasses were femoro-distal. Autogenous great saphenous vein (GSV) was used in all cases. All grafts were.

Mechanisms, Prevention and Treatment of Saphenous Vein

  1. It is estimated that 40% of saphenous vein grafts (SVG) are occluded and a higher number develop significant stenosis within 10 years after operation. 1 Our treatment options have been limited and disappointing. When treated with conventional percutaneous revascularization procedures, these lesions have a high incidence of subacute stent thrombosis, restenosis, and distal embolization
  2. Saphenous vein grafts (SVGs) yield high embolic risk. Predictable protection from embolic debris can help ensure better patient outcomes. Partner with Boston Scientific to mitigate the inherent risks of SVG interventions and master complex PCI. Patients undergoing PCI in SVGs may have increased risk of adverse events due to plaque embolization
  3. Laser treatment is mainly indicated for the treatment of varicosities in: Saphenous veins: long superficial veins running from the groin to the ankle. Reticular veins (feeder veins): dilated green and blue superficial veins. Telangiectasias: widened veins, causing patterns or red lines on the skin. However, the procedure is contraindicated if.
  4. Because saphenous vein graft failure accelerates 5 years after surgery, 4 it might be anticipated that any potential clinical benefit of radial artery grafting would become more (13.9%). Crossover, especially from the experimental to the control group, is known to dilute the treatment effect. 14 In the present study, the crossover rate.
  5. We estimated that failure of 1 or more vein grafts would occur in 25% of patients in the placebo group by 12 to 18 months after enrollment. 6,7 A total sample size of 1920 (960 patients per treatment group) had 91% power to detect a 25% reduction in vein graft failure using a 2-sided χ 2 test with an α level of .05. Enrollment of 2400.

UpToDat

  1. g. Three interlinked pathological processes - thrombosis, neointimal hyperplasia and atherosclerosis, which are temporally distinct, contribute to vein graft disease. 2, 3 Awareness of the processes and their ti
  2. In this randomised superiority trial, patients with de-novo saphenous vein graft lesions were assigned by computer-generated sequence (1:1:1:3) to receive either drug-eluting stents (one of three types: permanent-polymer paclitaxel-eluting stents, permanent-polymer sirolimus-eluting stents, or biodegradable-polymer sirolimus-eluting stents) or bare-metal stents
  3. T1 - Failure of a saphenous vein extracranial-intracranial bypass graft to protect against bilateral middle cerebral artery ischemia after carotid artery occlusion. T2 - Case report. AU - Bendok, Bernard R. AU - Murad, Ali. AU - Getch, Christopher C. AU - Batjer, H. Hunt. PY - 1999/8/1. Y1 - 1999/8/
  4. Causes and contributors to atherosclerosis, restenosis, and vein graft disease. Surgical treatment in arteries blocked by atherosclerotic plaque may result in restenosis or vein graft disease, caused by endothelial cell (EC) loss or dysfunction, neointimal formation (smooth muscle cell (SMC) proliferation and extracellular matrix synthesis), inflammation, thrombus incorporation into the vessel.

Saphenous vein graft disease - PubMe

Long-Term Outcomes With Drug-Eluting Stents Versus Bare Metal Stents in the Treatment of Saphenous Vein Graft Disease (Results from the REgistro Regionale AngiopLastiche Emilia-Romagna Registry) Luigi Vignali, MDa,*, Francesco Saia, MDb, Antonio Manari, MDe, Andrea Santarelli, MDf, Andrea Rubboli, MDc, Elisabetta Varani, MDg, Giancarlo Piovaccari, MDf, Alberto Menozzi, MDa, Gianfranco Percoco. Treating acute coronary syndromes involving a saphenous vein graft (SVG) remains a challenge for interventional cardiologists. Data from the Department of Veterans Affairs Cooperative Study showed a 10-year patency rate of SVGs at 61%. 1 Due to an aging population and a substantial number of coronary artery bypass grafting (CABG) procedures worldwide, recurrent ischemia and ACS due to SVG. Saphenous vein biopsy: A predictor of vein graft failure Michael L. Marin, Frank J. Veith, Thomas F. Panetta, Ronald E. Gordon, Kurt R. Wengerter, William D. Suggs, Luis Sanchez, Michael K. Parides Research output : Contribution to journal › Article › peer-revie SAFINOUS-CABG (Saphenous Vein Graft Failure—An Outcomes Study in Coronary Artery Bypass Grafting) group 2020, ' Development of a risk score for early saphenous vein graft failure: An individual patient data meta-analysis ', Journal of Thoracic and Cardiovascular Surgery, vol. 160, no. 1, pp. 116-127.e4

Preclinical success but clinical failure of the suturelessReal stress versus stretch ratio, a) longitudinal SV, bEndovascular Debulking in Therapy of Occluded Lower LimbTargeting Wnt/β-Catenin Activated Cells with DominantAntithrombotic treatment after coronary artery bypassThrombosis of the Inferior Vena Cava after Endovascular

Aneurysms of saphenous vein grafts to coronary arteries are unusual complications of coronary artery bypass graft (CABG) surgery. Three patients (men aged 47, 62, and 68 years) are presented with spontaneous chest pains 10, 21, and 17 years after CABG surgery. In one case, the saphenous vein graft had eroded into the right atrium and had established a fistula between the graft and the right. Conversely, there is still some reluctance in using arterial grafts because of the supposed augmented technical challenge and greater risk of post-operative complications as sternal dehiscence. 52 However, graft failure is hindering the outcomes of saphenous vein-based CABG as up to half patients may need repeated revascularization 10-15. Saphenous vein grafts (SVG) are vulnerable to degeneration and occlusion, leading to poorer long-term disease because of atherosclerotic degeneration. The main mechanism responsible for SVG failure is neointimal hyperplasia and the occluded SVG is treated with percutaneous coronary intervention, mostly with the use of additional protection devices • leg ulceration(s) due to saphenous vein insufficiency refractory to conservative management • recurrent bleeding from the saphenous vein or other varicosity • history of a significant episode of bleeding from a varicosity * Note: Sclerotherapy using a sclerosant approved by the U.S. Food and Drug Administration for the intended use Background Saphenous vein grafts develop an aggressive atherosclerotic process and the efficacy of drug eluting stents (DES) in treating saphenous vein graft (SVG) lesions has not been convincingly demonstrated. The aim of this study was to review and analyze the current literature for controlled studies comparing DES versus bare metal stents (BMS) for treatment of SVG stenoses