Which complication is associated with late graft stenosis after CABG?

Late graft stenosis after coronary artery bypass grafting (CABG) is particularly associated with the use of long saphenous vein grafts. The long saphenous vein is often harvested from the leg and used as a conduit for bypassing obstructed coronary arteries. While it is effective in the short term, it exhibits a higher tendency to develop arterial disease over time, leading to intimal hyperplasia and subsequent stenosis.

The mechanism behind this complication is multifaceted. The morphological and functional differences between venous and arterial conduits contribute to the long saphenous vein's susceptibility to degeneration. For instance, the vein adapts to arterial pressure and flow, undergoing structural changes, which can result in the formation of atherosclerotic changes. Additionally, venous grafts are influenced by factors like patient demographics, comorbidities, and the surgical technique used, which may affect their long-term patency.

In contrast, other graft types, such as internal thoracic artery grafts, are known for their excellent long-term patency and are less likely to experience late stenosis due to their arterial nature. Radial artery grafts have also shown favorable outcomes compared to saphenous vein grafts, although they might