Comparison of Conventional and No-Touch Techniques in Harvesting Saphenous Vein for Coronary Artery Bypass Grafting in View of Endothelial Damage

Şen, Onur; Gonca, Süheyla; Solakoğlu, Seyhun; Dalçik, Hakkı; Dalçįk, Cannur; Özkara, Ahmet

doi:10.1532/hsf98.20131006

Cited by 17 publications

(10 citation statements)

References 14 publications

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“…Moreover, it has not been determined whether EC denudation and loss is purely mechanical or is driven by EC activation and apoptosis in response to acute changes in unconditioned ECs. It is widely accepted that harvesting and implantation of LSV impacts on EC integrity to some degree [72] , though recent studies using improved surgical resection suggest that the endothelium is better preserved following surgery [73,74] . However, these studies fail to address the degree of dysfunction in the preserved endothelium.…”

Section: Intimal Hyperplasia and The Endotheliummentioning

confidence: 99%

Activation and inflammation of the venous endothelium in vein graft disease

et al. 2017

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The long saphenous vein is the most commonly used conduit in coronary artery bypass graft (CABG) surgery when bypassing multiple diseased arteries; however, its use is complicated by the development of vascular inflammation, intimal hyperplasia and accelerated atherosclerosis leading to compromised graft efficacy. Despite refinement of surgical techniques to improve graft patency, late vein graft failure remains a significant problem. Moreover, there is a lack of pharmacological interventions proven to be effective in the treatment of late vein graft failure. A greater understanding of the molecular nature of the disease and the interactions between endothelial and smooth muscle cells as a result of alterations in local haemodynamics may assist with designing future beneficial pharmacological interventions. Venous endothelial cells (ECs) are physiologically adapted to chronic low shear stress; however, once the graft is implanted into the arterial circulation, they become suddenly exposed to acute high levels of shear stress. A small number of in vitro and ex vivo studies have demonstrated that acute high shear stress is associated with the activation of a pro-inflammatory profile in saphenous vein ECs, which may be mediated by mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) signalling pathways. The impact of acute changes in shear stress on venous ECs and the role of ECs in the development of intimal hyperplasia remains incomplete and is the subject of this review.

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Section: Intimal Hyperplasia and The Endotheliummentioning

confidence: 99%

Activation and inflammation of the venous endothelium in vein graft disease

et al. 2017

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“…15) The preservation of the adventitial vasa vasorum and signs of normal cellular integrity demonstrated that the "no-touch" technique did not cause mechanical or pressure damage to the vessel wall. 16) LIMA graft is commonly harvested with a pedicle of surrounding tissue and is also avoided from dilation. The high patency rate of this arterial graft can partly be ascribed to the "no-touch" harvesting technique, especially for the beginner.…”

Section: Discussionmentioning

confidence: 99%

Stable Hemodynamics within “No-Touch” Saphenous Vein Graft

Jiang

Yang

Sun

et al. 2020

ATCS

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Purpose: To investigate the hemodynamics characteristics of the "no-touch" saphenous vein graft (SVG) conduits by nicardipine intraluminal administration in vivo experiment. Methods: A total of 59 consecutive patients were enrolled and underwent a sequential SVG to three non-left anterior descending (LAD) targets with the average runoff ≤2 mm, 30 with "no-touch" harvest technique (group A) and 29 with conventional preparation (group B). The patients were subject to nicardipine intraluminal injection during offpump coronary artery bypass grafting (CABG) procedure. The intraoperative flow was measured with the ultrasonic transit time flow meter (TTFM), and the graft patency testified by multi-detector computed tomography (MDCT) angiography, respectively. Results: The baseline blood flow was higher in group A than that in group B (p <0.05). However, the increases in blood flow of SVG conduits in group A were lower than those in group B with 19.7 ± 5.9 vs. 35.4 ± 9.2 mL/min, 14.8 ± 5.6 vs. 23.1 ± 6.8 mL/min, 6.6 ± 2.1 vs. 11.2 ± 4.3 mL/min before the first, second, and third anastomose after nicardipine intraluminal administration, respectively (all p <0.01). Conclusions: No-touch SVGs were associated with higher baseline blood flow and less rises after nicardipine intraluminal administration during off-pump CABG procedure compared with conventional preparation. The no-touch SVGs seemed to be less spastic and well-tolerated on flow dilatation.

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“…A bridging technique, which involves making several smaller “skip incisions,” was identified as an effective solution in reducing wound complications in comparison with the long incision approach . The conventional saphenectomy approach involves the longitudinal opening of the fascial canal surrounding the vein, formed predominantly by adipose tissue . In doing so, the adventitial layer is invariably damaged, leading to saphenous vein venospasm .…”

Section: Conventional Open Vein Harvesting Techniquementioning

confidence: 99%

“…The conventional saphenectomy approach involves the longitudinal opening of the fascial canal surrounding the vein, formed predominantly by adipose tissue . In doing so, the adventitial layer is invariably damaged, leading to saphenous vein venospasm . The high distension pressures required to overcome venospasm and to check for vascular leaks before graft implantation induces substantial damage to the vein at an ultrastructural level .…”

Section: Conventional Open Vein Harvesting Techniquementioning

confidence: 99%

Long saphenous vein harvesting techniques and their effect on graft patency

et al. 2019

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Coronary artery bypass grafting is a key cardiac surgery procedure and is the main treatment for patients with multivessel coronary artery disease. The most frequently used conduit for this procedure is the long saphenous vein (LSV). The technique of harvesting the LSV has evolved over the last 30 years from total open harvesting to endoscopic with minimal access technique. The most important determining factor for success in coronary artery surgery is the graft patency rate. The literature evidence behind each technique has been reported at different levels and there is an ongoing debate about which technique can provide optimum vein patency over the long term. This literature review aims to summarize the current evidence, the implications involved with the use of each technique for harvesting LSV and the patency rate at variable follow‐up intervals.

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Comparison of Conventional and No-Touch Techniques in Harvesting Saphenous Vein for Coronary Artery Bypass Grafting in View of Endothelial Damage

Cited by 17 publications

References 14 publications

Activation and inflammation of the venous endothelium in vein graft disease

Activation and inflammation of the venous endothelium in vein graft disease

Stable Hemodynamics within “No-Touch” Saphenous Vein Graft

Long saphenous vein harvesting techniques and their effect on graft patency

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