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31-Jan-2018 14:43

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The internal mammary artery (IMA) grafts have been associated with long-term patency and improved survival as compared to saphenous vein grafts (SVGs).Early failure of IMA is attributed to poor surgical technique and less with thrombosis.SVGs implanted for over one year show arterialization and fibrointimal thickening that consists of SMCs, proteoglycans, and type I and III collagen.The degree of intimal thickening varies and is reported to be usually 75% narrowing from neointimal tissue only (11).The intimal thickening consisted of SMCs, proteoglycan, collagen and elastin fibers with luminal endothelial cells.

Intimal thickening has been described to be almost always seen in vein grafts at the time of implantation; however, in 90% of cases it occupies It is well known that SVGs are susceptible to accelerated atherosclerosis as compared to native coronary arteries or IMAs, thus limiting the long term benefits of coronary artery bypass graft (CABG) surgery with SVGs.

SVGs at the time of implantation show focal absence of endothelium with platelet and fibrin deposition along the intimal surface.

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