What is the optimal management for preventing saphenous vein graft diseases?: early results of intravascular angioscopic assessment.
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.


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.
Hata
Mitsumasa
M
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. mihata@med.nihon-u.ne.jp
Sezai
Akira
A
Niino
Tetsuya
T
Yoda
Masataka
M
Wakui
Shinji
S
Chiku
Masaaki
M
Takayama
Tadateru
T
Honye
Junko
J
Saitoh
Satoshi
S
Minami
Kazutomo
K
D000368:Aged; D000369:Aged, 80 and over; D017546:Angioscopy / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000379:methods; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012501:Saphenous Vein / Q000473:pathology* / Q000637:transplantation*; D013988:Ticlopidine / Q000627:therapeutic use
D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D001241:Aspirin