What is a disadvantage of a saphenous vein graft?

• A. More likely to demonstrate advancing CAD
• B. Superior durability
• C. Less risk of occlusion
• D. Higher patency than arterial grafts

Answer: (A)

The main idea is that saphenous vein grafts tend to lose patency over time due to accelerated atherosclerosis and occlusion once placed in the arterial circulation. Vein grafts are exposed to higher arterial pressures, which promotes intimal hyperplasia and progressive atherosclerotic changes, making them more prone to failure as time goes on. So, they are more likely to demonstrate advancing disease in the graft compared with arterial grafts, reflecting their overall disadvantage in long-term durability. The other statements imply the opposite—vein grafts are not more durable, do not have less risk of occlusion, and do not have higher patency than arterial grafts.