IMR Press / RCM / Volume 23 / Issue 7 / DOI: 10.31083/j.rcm2307232
Open Access Systematic Review
Percutaneous Coronary Intervention of Native Artery Versus Bypass Graft in Patients with Prior Coronary Artery Bypass Graft Surgery
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1 Cardiothoracic Department, Freeman Hospital, NE7 7DN Newcastle upon Tyne, UK
2 School of Life and Medical Sciences, University of Hertfordshire, AL10 9AB Hertfordshire, UK
3 Minneapolis Heart Institute Foundation, Minneapolis, MN 55407, USA
4 Department of Invasive Cardiology, Humanitas Clinical and Research Center IRCCS, 20089 Rozzano, Milan, Italy
5 Department of Cardiology, St George's University Hospitals NHS Foundation Trust, SW17 0QT London, UK
6 Newcastle University Translational and Clinical Research Institute, NE1 7RU Newcastle upon Tyne, UK
*Correspondence: (Mohaned Egred)
Academic Editors: George Dangas and Christian Hengstenberg
Rev. Cardiovasc. Med. 2022, 23(7), 232;
Submitted: 29 January 2022 | Revised: 29 March 2022 | Accepted: 29 April 2022 | Published: 24 June 2022
(This article belongs to the Special Issue Recent Advances in Percutaneous Coronary Intervention)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Percutaneous coronary intervention (PCI) is common in patients with prior coronary artery bypass graft surgery (CABG), however, there is limited data on the association between the PCI target-vessel and clinical outcomes. In this article, we provide a state-of-the-art overview of the contemporary management of patients with prior CABG and a clear indication for revascularization. Methods: We performed a structured literature search of PubMed and Cochrane Library databases from inception to March 2021. Relevant studies were extracted and synthesized for narrative review. Results: Twenty-six observational studies focusing on PCI of bypass graft versus native coronary artery lesions in 366,060 patients with prior CABG were included. The data from observational studies suggest that bypass graft PCI is associated with higher short- and long-term major adverse cardiac events compared to native coronary artery PCI. Conclusions: Whenever feasible, native coronary artery PCI should be the prioritized treatment for saphenous vein graft failure. Prospective randomized trials are needed to elucidate the optimal revascularization strategy for patients with prior CABG.

vein graft
native artery
Fig. 1.
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