Improved patency in vein grafts harvested with surrounding tissue: results of a randomized study using three harvesting techniques

Souza, Domingos; Dashwood, Michael R.; Tsui, Janice; Filbey, Derek; Bodin, Lennart; Johansson, Benny; Borowiec, Jan

doi:10.1016/s0003-4975(02)03425-2

Cited by 174 publications

(172 citation statements)

References 23 publications

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“…On this point, in a study performed to improve venous graft patency, 3 harvesting techniques were compared and it was concluded that preserving the saphenous vein endothelium, adventitia and surrounding tissue, using a "notouch" technique, abolished intraoperative venospasm and resulting in improved graft patency. 30 In addition, Dashwood et al reported that perivascular fat-derived nitric oxide had a beneficial role in vein grafts that had been atraumatically harvested. 31 Finally, Souza et al 32 demonstrated that harvesting saphenous vein to be used in coronary bypass with its intact adventitia and surrounding tissues was associated with high short-and long-term patency rates of the venous grafts.…”

Section: Clinical Relevancementioning

confidence: 99%

Effects of Removing the Adventitia on the Mechanical Properties of Ovine Femoral Arteries In Vivo and In Vitro

Fischer

Santana

Zócalo

et al. 2010

Circ J

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Background:The aims were to characterize in muscular arteries (a) the passive and active effects of the adventitia on vessel biomechanical properties and conduit function (CF), and (b) potential differences between the adventitial role in elastic and muscular arteries. Methods and Results:Ovine femoral arteries were studied in vivo and in vitro (reduced smooth muscle-tone) in a circulation mock-up during hemodynamic conditions similar to those found in vivo. Pressure and diameter were assessed before and after removing the adventitia. The arterial compliance, distensibility, stiffness β-index and CF were quantified. Results were compared with those obtained in brachiocephalic trunks. In vivo, after removing the adventitia there was a nonsignificant diameter reduction and an increase in stiffness (P<0.05). The CF decreased in the early recordings (P<0.02). In vitro, there were no biomechanical changes but vascular dilatation after the adventitia removal. Biomechanical changes associated with the adventitia removal were higher in muscular arteries, whereas diameter changes were major in elastic vessels. Conclusions:After removing the adventitia, (a) the arterial stiffness and CF were modified in vivo only, suggesting the changes could be ascribed to variations in smooth muscle tone, and (b) changes in elastic and muscular arteries were quantitatively different. (Circ J 2010; 74: 1014 - 1022

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Section: Clinical Relevancementioning

confidence: 99%

Effects of Removing the Adventitia on the Mechanical Properties of Ovine Femoral Arteries In Vivo and In Vitro

Fischer

Santana

Zócalo

et al. 2010

Circ J

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“…37,38 This also means that the remaining 50% of SvGs remain patent beyond the 10-year cutoff ( Figure 2B). However, more recent reports suggest SvG patency rates as high as >80% at long-term follow-up in some centers, possibly as a result of improved management of postoperative antiplatelet function, refinement of surgical approaches with the use of less invasive SvG harvesting techniques, 42 and a better understanding of the mechanisms involved in the development of inflammation and intimal hyperplasia of vein grafts. [43][44][45] For example, the 7-year patency rates of the Beating Heart Against Cardioplegic Arrest Studies (BHACAS) assessed with multislice computed tomography scans showed an overall 89% patency rate in both the on-pump and off-pump groups despite the use of SvGs for ≈75% of grafts.…”

Section: Cabg Revascularization Of Ctos With Svgsmentioning

confidence: 99%

Should Chronic Total Occlusion Be Treated With Coronary Artery Bypass Grafting?

2016

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“…The SVG diameter-patency relationship elicited in this study implies that distal veins may have better patency than proximal veins, which is consistent with a previous study. 24 However, in the CASCADE trial, SVGs were harvested almost exclusively from the thigh, in an open fashion, and the 1-year angiographic patency rate of SVGs was high at 93.8%, encouraging one to continue using upper leg veins.…”

Section: Graft Size and Svg Remodelingmentioning

confidence: 99%

Correlates of Saphenous Vein Graft Hyperplasia and Occlusion 1 Year After Coronary Artery Bypass Grafting

et al. 2013

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Background— Intimal hyperplasia of saphenous vein grafts (SVGs) can lead to subsequent graft atherosclerosis and occlusion after coronary artery bypass grafting (CABG). This study examined whether patient characteristics, anatomic factors, and medications are associated with SVG intimal hyperplasia and occlusion after CABG. Methods and Results— We performed a post hoc analysis of the Clopidogrel After Surgery for Coronary Artery Disease (CASCADE) trial, where 322 grafts were assessed by angiography and 90 grafts were examined by intravascular ultrasound at 1 year after CABG. We assessed the following correlates for intimal hyperplasia and occlusion: patient characteristics, discharge medications, target vessel characteristics, and SVG diameter. At 1 year, the SVG mean intimal area was 4.3±2.1 mm 2 , and the occlusion rate was 6.2% (13/209). Independent correlates of hyperplasia were larger SVG diameter (1.9±0.2 mm 2 /mm; P <0.001), hypertension (0.7±0.3 mm 2 ; P =0.03), and grafting to the right coronary territory (0.6±0.3 mm 2 ; P =0.03), whereas statin (−0.8±0.3 mm 2 ; P =0.01) and β-blocker use (−1.0±0.4 mm 2 ; P =0.03) were associated with less hyperplasia. Low target vessel quality was an independent correlate of SVG occlusion (odds ratio, 5.2±3.1; P <0.01). Conclusions— Hypertension, SVG diameter, grafting to the right coronary artery, and low quality of the target vessel correlate with the development of SVG hyperplasia or occlusion by 1 year after CABG, whereas β-blockers and statins are associated with less SVG disease. These new findings further our understanding of SVG remodeling after bypass surgery and may guide future research to help prevent post-CABG SVG disease. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00228423

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Improved patency in vein grafts harvested with surrounding tissue: results of a randomized study using three harvesting techniques

Cited by 174 publications

References 23 publications

Effects of Removing the Adventitia on the Mechanical Properties of Ovine Femoral Arteries In Vivo and In Vitro

Effects of Removing the Adventitia on the Mechanical Properties of Ovine Femoral Arteries In Vivo and In Vitro

Should Chronic Total Occlusion Be Treated With Coronary Artery Bypass Grafting?

Correlates of Saphenous Vein Graft Hyperplasia and Occlusion 1 Year After Coronary Artery Bypass Grafting

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