Cor Vasa 2026, 68(4):494-502 | DOI: 10.33678/cor.2026.002

Saphenous Vein Graft in Coronary Artery Bypass Grafting (CABG) Surgery: Combating Thrombosis, Intimal Hyperplasia and Atherosclerosis in Maintaining Long-Term Graft Patency.

Gold Sunday Palm Tampubolona, Yan Efrata Sembiringa, Oky Revianto Sediono Pribadib, Chikita Nur Rachmib, Danang Himawan Limantoa, Jeffrey Jeswant Dillonc, Ito Puruhitoa
a Department of Thoracic, Cardiac and Vascular Surgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
b Department of Thoracic, Cardiac and Vascular Surgery, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
c Institut Jantung Negara, Department of Cardiology and Department of Cardiothoracic Surgery, Kuala Lumpur, Malaysia

Aim: Gaining further insight to enhance treatment to stop the progression of saphenous vein grafts (SVG) disease, given the interest in using saphenous veins as grafts in coronary artery bypass graft (CABG).

Methods: This comprehensive review synthesizes the current standards, contemporary treatment, and results related to coronary arterial bypass grafting using SVG, exploring a variety of methods and developments that have the potential to improve both immediate and long-term graft patency. Understanding pathophysiology of SVG disease and where it leads to suggest potential new treatments for the condition.

Results: Failure of SVG can be the results of thrombosis, intimal hyperplasia, and atherosclerosis. Acute thrombosis caused by hypercoagulability, conduit-related pathology, or technical such as graft trauma and anastomotic defects. The migration and proliferation of vascular smooth muscle cells (VSMCs) in the tunica intima layer is the main pathophysiology of intimal hyperplasia. Endothelial dysfunction or damage from vascular injury is the first step that sets off the process. This review narrates SVG graft-to-implant strategies that include graft selection, harvesting technique, careful graft assessment techniques, graft preservation, and technology-assisted techniques. The review also covers pharmacotherapy that targets distinct stages of the SVG condition to prevent and treat neointimal hyperplasia.

Conclusion: Improving long-term SVG patency requires integration of optimized surgical techniques, rigorous pharmacological regimens, and novel adjunctive strategies. Continued translational research into vascular biology and biotechnology is crucial to reducing SVG failure rates and improving patient survival after CABG. © 2026, ČKS.

Keywords: Atherosclerosis, Coronary artery bypass graft, surgery, Coronary artery disease, Graft patency, Intimal hyperplasia

Received: November 25, 2025; Revised: January 12, 2026; Accepted: January 13, 2026; Prepublished online: August 21, 2026; Published: August 31, 2026  Show citation

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Sunday Palm Tampubolon G, Efrata Sembiring Y, Revianto Sediono Pribadi O, Rachmi CN, Himawan Limanto D, Dillon JJ, Puruhito I. Saphenous Vein Graft in Coronary Artery Bypass Grafting (CABG) Surgery: Combating Thrombosis, Intimal Hyperplasia and Atherosclerosis in Maintaining Long-Term Graft Patency. Cor Vasa. 2026;68(4):494-502. doi: 10.33678/cor.2026.002.
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