Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In the PREVENT (Project of Ex-vivo Vein Graft Engineering via Transfection) IV study, the PREVENT IV investigators1 found a high proportion of saphenous vein graft failure (VGF) (>25% of grafts) occurring within the first 12 to 18 months after coronary artery bypass graft (CABG) surgery, with more than 40% of the patients who underwent CABG surgery having at least 1 graft occluded within this period. Moreover, pretreatment of harvested saphenous veins with the E2F transcription factor decoy edifoligide with the aim of preventing neointimal hyperplasia and accelerated atherosclerosis did not reduce the failure rate of the venous conduits. The PREVENT IV investigators suggest that a substantial proportion of venous graft failures takes place early in the perioperative period as major adverse cardiac events occur soon after surgery, more frequently in association with graft failure, but they do not provide an explanation for this phenomenon.
Parolari A, Alamanni F, Tremoli E, Biglioli P. Efficacy and Safety of Edifoligide. JAMA. 2006;295(13):1513-1515. doi:10.1001/jama.295.13.1513-a