Risk Factors Associated With Saphenous Vein Graft In-Stent Restenosis Publisher



Amirzadegan A ; Ebadi R ; Khederlou H ; Karami Dehkordi P ; Karimi Z
Source: General Thoracic and Cardiovascular Surgery Published:2026

Abstract

Objective: This study examined the risk factors of in-stent restenosis (ISR) group after saphenous vein grafts (SVGs) percutaneous coronary intervention. Methods: From March 2007 to February 2021, we collected 385 cases of SVGs percutaneous coronary intervention at the Tehran heart center. Patients experiencing ischemic symptoms were examined during follow-ups by cardiologists, who recommended a second coronary artery angiography. On the basis of coronary artery angiography, the cases were classified as ISR group (n = 284) or non-ISR group (n = 101). The medical history, biochemical indicators, coronary artery lesion features, and stent characteristics were retrospectively evaluated. Using univariate and multivariable Cox regression, risk factors for ISR group have been discovered. Results: SVG ISR group was verified in 284 of the total number of patients (73.8%). The median length of follow-up was 8.6 years (95% CI = 7.1–10.0 years). Lower body mass index (HR = 0.95, 95% CI = 0.92–0.98, p = 0.006), lower left ventricular ejection fraction (HR = 0.94, 95% CI = 0.91–0.99, p = 0.001), and longer stent length (HR = 1.03, 95% CI = 1.01–1.05, p = 0.002), remained independently associated with ISR group after multivariable analysis. Conclusion: Lower body mass index, lower left ventricular ejection fraction, and longer stent length are independent predictors of ISR group after SVGs percutaneous coronary intervention. © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2026.