Since the introduction of venous coronary bypass grafting in 1968, venous graft disease remains a major therapeutic challenge. The alternative to surgical reintervention is saphenous vein graft angioplasty with the combination of distal protection and drug eluting stents, available since 2002. Although randomised controlled evaluation is still lacking, the early results at 6 months are safe and favourable with a stent thrombosis rate below 1,5% and a target lesion revascularisation rate near 5%, according to several registries in 2005.