Understanding saphenous vein graft patency.

Saphenous vein was the conduit used in the first series of coronary surgery, and, with the exception of revascularization of the left anterior descending coronary artery, it remains the most commonly used conduit.1 There are several reasons for this. First, because of its relatively large diameter and wall characteristics, it is technically easy to use; second, it is plentiful, and therefore can be used to perform multiple grafts; third, it is long and can reach any coronary artery; and fourth, it is easily harvested. However, its durability and longevity are not ideal. One year after coronary surgery, 10% to 20% of saphenous vein grafts fail.2–4 From 1 to 5 years, an additional 5% to 10% fail, and from 6 to 10 years, an additional 20% to 25% fail.5 At 10 years, only about half of saphenous vein grafts are patent, and of those, only half are free of angiographic arteriosclerosis.6