Compare patency and typical use of SVGs versus arterial grafts.

• A. SVGs have good early patency but deteriorate over time, whereas arterial grafts have higher long-term patency.
• B. SVGs have higher long-term patency than arterial grafts.
• C. SVGs and arterial grafts have identical patency.
• D. Saphenous vein grafts are contraindicated in multivessel disease.

Answer: (A)

In CABG practice, patency patterns differ between saphenous vein grafts and arterial grafts. Saphenous vein grafts tend to show good patency early after surgery, but their durability fades over time due to vein-specific changes such as intimal hyperplasia and progressive atherosclerosis when exposed to arterial pressure and flow. Arterial grafts, like the left internal mammary artery or radial artery, resist these processes and maintain high patency over the long term, making them more durable for durable revascularization.

That’s why arterial grafts are favored for the most important, long-lasting targets (for example, LIMA to the LAD), while saphenous vein grafts are commonly used to reach additional targets or in multivessel disease when arterial conduits are limited. So the best description is that SVGs have good early patency but deteriorate over time, whereas arterial grafts have higher long-term patency.