Abstract
Despite the acknowledgement of the superiority of coronary artery bypass grafts, the great saphenous vein remains a vein graft
which is most frequently used in coronary surgery. After grafting venous conduits are susceptible to fibrous intimal hyperplasia
and to severe atherosclerosis with ulceration and thrombosis which lead to the dysfunction – stenosis and graft occlusion
in the short- and long-term periods after the operation.
In recent years active treatment of atherosclerosis with lipid-lowering medications, diet and hypertension control made it possible
to reduce changes, occurring in vein grafts. With secondary prophylaxis the new pharmacological preparations and their
combinations will ensure more advanced control options for the fight with atherosclerosis progression not only in the native
coronary arteries, but in the grafts as well.
The present article reviews pathophysiological changes in vein grafts both in the short-term and long-term periods. It describes
surgical and traditional (pharmacological) methods of their prevention, and also the use of supporting devices for vein grafts,
of cytostatic preparations and genetic engineering.
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