[1]谢超凡 随永刚 杨诚 钱杰.静脉桥病变及其介入治疗进展[J].心血管病学进展,2026,(1):6.[doi:10.16806/j.cnki.issn.1004-3934.2026.01.002]
 XIE Chaofan,SUI Yonggang,YANG Cheng,et al.Saphenous Vein Graft Disease and Its Interventional Therapy[J].Advances in Cardiovascular Diseases,2026,(1):6.[doi:10.16806/j.cnki.issn.1004-3934.2026.01.002]
点击复制

静脉桥病变及其介入治疗进展()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2026年1期
页码:
6
栏目:
综述
出版日期:
2026-01-25

文章信息/Info

Title:
Saphenous Vein Graft Disease and Its Interventional Therapy
作者:
谢超凡1 随永刚 2 杨诚 3 钱杰 4
(中国医学科学院阜外医院心血管内科,北京 100037)
Author(s):
XIE Chaofan1SUI Yonggang2YANG Cheng3QIAN Jie4
(Department of Cardiology,Chinese Academy of Medical Sciences Fuwai HospitalBeijing 100037,China)
关键词:
静脉桥病理生理学机制直接支架植入准分子激光冠状动脉消融术
Keywords:
Saphenous vein graftPathophysiological mechanismDirect stent implantationExcimer laser coronary artery ablation
DOI:
10.16806/j.cnki.issn.1004-3934.2026.01.002
摘要:
外科冠状动脉旁路移植术是一项治疗冠状动脉粥样硬化十分重要的手段,该治疗最常使用的桥血管材料为静脉桥。随着时间的流逝,静脉桥10年随访的再狭窄率>50%,而对于此时静脉桥病变的治疗,最常使用的是介入手段。现主要从静脉桥病变的病理生理学机制以及静脉桥病变的诊断、干预、介入治疗等方面进行相关论述。
Abstract:
Surgical coronary artery bypass grafting is a very important treatment for coronary atherosclerosis,and the most used bridging materials for this treatment are saphenous vein grafts. With the passage of time,the restenosis rate of saphenous vein grafts in 10-year follow-up can reach more than 50%. For the treatment of saphenous vein graft disease at this stage,interventional methods are most commonly used. This article mainly discusses the pathophysiological mechanism of saphenous venous graft disease,as well as the diagnosis,intervention and interventional treatment of saphenous venous graft disease

参考文献/References:

[1] 刘明波,何新叶,杨晓红,等. 《中国心血管健康与疾病报告2023》要点解读[J]. 中国心血管杂志,2024,29(4):305-324.

[2] Neumann FJ,Sousa-Uva M,Ahlsson A,et al. 2018 ESC/EACTS Guidelines on myocardial revascularization[J]. EuroIntervention,2019,14(14):1435-1534.

[3] Karaaslan ??,Maden O,Kanal Y,et al. Association of CABG SYNTAX score with long term clinical outcomes in patients with acute myocardial infarction undergoing SVG PCI[J]. Eur Rev Med Pharmacol Sci,2022,26(11):3893-3902.

[4] Back L,Ladwiniec A. Saphenous vein graft failure:current challenges and a review of the contemporary percutaneous options for management[J]. J Clin Med,2023,12(22):7118.

[5] Beerkens FJ,Claessen BE,Mahan M,et al. Contemporary coronary artery bypass graft surgery and subsequent percutaneous revascularization[J]. Nat Rev Cardiol,2022,19(3):195-208.

[6] Harskamp RE,Lopes RD,Baisden CE,et al. Saphenous vein graft failure after coronary artery bypass surgery:pathophysiology,management,and future directions[J]. Ann Surg,2013,257(5):824-833.

[7] Xenogiannis I,Zenati M,Bhatt DL,et al. Saphenous vein graft failure:from pathophysiology to prevention and treatment strategies[J]. Circulation,2021,144(9):728-745.

[8] Jeremy JY,Rowe D,Emsley AM,et al. Nitric oxide and the proliferation of vascular smooth muscle cells[J]. Cardiovasc Res,1999,43(3):580-594.

[9] Osgood MJ,Hocking KM,Voskresensky IV,et al. Surgical vein graft preparation promotes cellular dysfunction,oxidative stress,and intimal hyperplasia in human saphenous vein[J]. J Vasc Surg,2014,60(1):202-211.

[10] Cheung-Flynn J,Song J,Voskresensky I,et al. Limiting injury during saphenous vein graft preparation for coronary arterial bypass prevents metabolic decompensation[J]. Sci Rep,2017,7(1):14179.

[11] McKavanagh P,Yanagawa B,Zawadowski G,et al. Management and prevention of saphenous vein graft failure:a review[J]. Cardiol Ther,2017,6(2):203-223.

[12] Xenogiannis I,Tajti P,Hall AB,et al. Update on cardiac catheterization in patients?with?prior coronary artery bypass?graft?surgery[J]. JACC Cardiovasc Interv,2019,12(17):1635-1649.

[13] Mushtaq S,Conte E,Pontone G,et al. Interpretability of coronary CT angiography performed with a novel whole-heart coverage high-definition CT scanner in 300 consecutive patients with coronary artery bypass grafts[J]. J Cardiovasc Comput Tomogr,2020,14(2):137-143.

[14] Jones DA,Beirne AM,Kelham M,et al. Computed tomography cardiac angiography before invasive coronary angiography in patients with previous bypass surgery:the BYPASS-CTCA trial[J]. Circulation,2023,148(18):1371-1380.

[15] Farag M,Brilakis ES,Gasparini GL,et al. Percutaneous coronary intervention of native artery versus bypass graft in patients with prior coronary artery bypass graft surgery[J]. Rev Cardiovasc Med,2022,23(7):232.

[16] Abdelrahman A,D?bski M,More R,et al. One-year outcomes of percutaneous coronary intervention in native coronary arteries versus saphenous vein grafts in patients with prior coronary artery bypass graft surgery[J]. Cardiol J,2022,29(3):396-404.

[17] Mavroudis CA,Kotecha T,Chehab O,et al. Superior long term outcome associated with native vessel versus graft vessel PCI following secondary PCI in patients with prior CABG[J]. Int J Cardiol,2017,228:563-569.

[18] Brilakis ES,O’Donnell CI,Penny W,et al. Percutaneous coronary intervention in?native coronary arteries versus bypass?grafts in patients with prior coronary artery bypass graft surgery:insights from the veterans affairs clinical assessment,reporting,and tracking program[J]. JACC Cardiovasc Interv,2016,9(9):884-893.

[19] Lawton JS,Tamis-Holland JE,Bangalore S,et al. 2021 ACC/AHA/SCAI Guideline for coronary artery revascularization:executive summary:a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation,2022,145(3):e4-e17.

[20] de Winter RW,Walsh SJ,Hanratty CG,et al. Percutaneous coronary intervention of native coronary artery versus saphenous vein graft in patients with prior coronary artery bypass graft surgery:rationale and design of the multicenter,randomized PROCTOR trial[J]. Am Heart J,2023,257:20-29.

[21] de Winter RW,Hoek R,Walsh SJ,et al. PCI of native coronary artery vs saphenous vein graft after prior bypass surgery:a multicenter,randomized trial [J]. J Am Coll Cardiol,2025 Oct 28:S0735-1097(25)09477-X. DOI: 10.1016/j.jacc.2025.09.1577. Epub ahead of print.

[22] Rigattieri S,Sciahbasi A,Brilakis ES,et al. Meta-analysis of radial versus femoral artery approach for coronary procedures in patients with previous coronary artery bypass grafting[J]. Am J Cardiol,2016,117(8):1248-1255.

[23] Israeli Z,Lavi S,Pancholy SB,et al. Radial versus femoral approach for saphenous vein grafts angiography and interventions[J]. Am Heart J,2019,210:1-8.

[24] Michael TT,Alomar M,Papayannis A,et al. A randomized comparison of the transradial and transfemoral approaches for coronary artery bypass graft angiography and intervention:the RADIAL-CABG Trial (RADIAL Versus Femoral Access for Coronary Artery Bypass Graft Angiography and Intervention)[J]. JACC Cardiovasc Interv,2013,6(11):1138-1144.

[25] Brilakis ES,Edson R,Bhatt DL,et al. Drug-eluting stents versus bare-metal stents in saphenous vein grafts:a double-blind, randomised trial[J]. Lancet,2018,391(10134):1997-2007.

[26] Patel NJ,Bavishi C,Atti V,et al. Drug-eluting stents versus bare-metal stents in saphenous vein graft intervention[J]. Circ Cardiovasc Interv,2018,11(11):e007045.

[27] Mehilli J,Pache J,Abdel-Wahab M,et al. Drug-eluting versus bare-metal stents in saphenous vein graft lesions(ISAR-CABG):a randomised controlled superiority trial[J]. Lancet,2011,378(9796):1071-1078.

[28] M?lstad PM,Nordrehaug JE,Steigen TK,et al. Drug-eluting versus bare-metal stents in saphenous vein grafts compared to native coronary vessels:The Norwegian Coronary Stent Trial Study[J]. Cardiology,2022,147(1):14-22.

[29] Saidi-Seresht S,James S,Erlinge D,et al. Outcome of saphenous vein graft percutaneous coronary intervention using contemporary drug-eluting stents:a SCAAR report[J]. J Soc Cardiovasc Angiogr Interv,2024,3(10):102232.

[30] Medranda GA,Nathan S.Contemporary saphenous vein graft intervention:new insights but still more questions[J]. J Soc Cardiovasc Angiogr Interv,2024,3(10):102282.

[31] Kuna C,Wiedenmayer N,Bradaric C,et al. Ten-year outcomes after percutaneous coronary intervention of in-stent restenosis in saphenous vein grafts[J]. Catheter Cardiovasc Interv,2023,102(4):646-654.

[32] Fahrni G,Farah A,Engstr?m T,et al. Long-term results after drug-eluting versus bare-metal stent implantation in saphenous vein grafts:randomized controlled trial[J]. J Am Heart Assoc,2020,9(20):e017434.

[33] Latif F,Uyeda L,Edson R,et al. Stent-only versus adjunctive balloon angioplasty approach for saphenous vein graft percutaneous coronary intervention: insights from DIVA trial[J]. Circ Cardiovasc Interv,2020,13(2):e008494.

[34] Authors/Task Force members;Windecker S,Kolh P,et al. 2014 ESC/EACTS Guidelines on myocardial revascularization:The Task Force on Myocardial Revascularization of the European Society of Cardiology(ESC) and the European Association for Cardio-Thoracic Surgery(EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions(EAPCI)[J]. Eur Heart J,2014,35(37):2541-2619.

[35] Han Y,Jing QM,Wang QC,et al. Percutaneous recanalization of total saphenous vein graft occlusion with excimer laser treatment[J]. J Geriatr Cardiol,2020,17(4):234-240.

[36] 翟光耀,孙铁男,李响,等. 准分子激光冠状动脉成形术治疗大隐静脉桥血管退行性变的前瞻性研究[J]. 中华心血管病杂志,2023,51(5):490-496.

[37] Golino L,Caiazzo G,Calabrò P,et al. Excimer laser technology in percutaneous coronary interventions:cardiovascular laser society’s position paper[J]. Int J Cardiol,2022,350:19-26.

相似文献/References:

[1]代棠瑜 钱海燕 王蕾.G蛋白偶联受体120在心血管疾病中的机制及转化研究进展[J].心血管病学进展,2026,(2):159.[doi:10.16806/j.cnki.issn.1004-3934.2026.02.013]
 DAI Tangyu,QIAN Haiyan,WANG Lei.Mechanisms and Translational Research of G protein-coupled receptor 120 in Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2026,(1):159.[doi:10.16806/j.cnki.issn.1004-3934.2026.02.013]

更新日期/Last Update: 2026-05-14