Angioplasty of venous grafts.

Degeneration of venous aorto-coronary bypass grafts results in a reduction in their patency: 60% are patent at 10 years and only 50% are disease-free. Balloon angioplasty has been proposed as a therapeutic alternative to surgi cal reoperation. This delicate technique is associated with immediate, medi um and long-term results which are less satisfactory than those obtained on the native coronary vessels. The risk of distal embolisation influences th e immediate operative results. Restenosis, more common than after angioplas ty of native vessels, and the progression of atherosclerosis, explain the m ediocre long-term results. Of all the techniques of interventional cardiolo gy, coronary stenting seems to provide the best results, especially on shor t, focal lesions. The immediate and long-term results are more disappointin g in cases of diffuse degeneration of the graft. The pre-, peri- and postoperative medical environment, especially treatment with platelet inhibitors and statins, seems to play a decisive part in the improvement of long-term clinical results.