Consequently, when small-bore vessel replacement is needed (e.g., for coronary artery bypass surgeries), the grafts are fashioned either from autologous saphenous vein (taken from the patient’s own leg) or left internal mammary artery. The long-term patency of saphenous vein grafts is only 50% at 10 years; these grafts occlude through thrombosis (typically early), intimal thickening (months to years postoperatively), and vein graft atherosclerosis. By contrast, more than 90% of internal mammary artery grafts are patent after 10 years.
BA*.
Fig. 10.32 Restenosisafterangioplastyandstenting.(A)Grossviewdemonstratingresidualatheroscleroticplaque(arrows) andanew,glisteningintimalproliferativelesion.(B)Histologicviewshowsathickenedneointimaoverlyingthestentwires(black diamond indicated by the arrow), whichencroachesonthelumen(asterisk). (B, Reproduced from Schoen FJ, Edwards WD: Pathology of cardiovascular interventions, including endovascular therapies, revascularization, vascular replacement, cardiac assist/replacement, arrhythmia control, and repaired congenital heart disease. In Silver MD, et al., editors: Cardiovascularpathology, ed 3, Philadelphia, 2001, Churchill Livingstone.)
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