Long-Term Patency Rate for Radial Artery vs. Saphenous Vein Grafts Using Same-Patient Materials

Hata, Mitsumasa; Yoshitake, Isamu; Wakui, Shinji; Unosawa, Satoshi; Kimura, Haruka; Hata, Hiroyuki; Shiono, Motomi

doi:10.1253/circj.cj-10-1174

Cited by 21 publications

(21 citation statements)

References 25 publications

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“…Slevin et al 15 have also shown that arterial grafts yield a lower incidence of myocardial infarction, lower reoperation rates, and longer survival rates. Other authors, [16][17][18] however, have shown comparable graft patency rates between radial artery and great saphenous vein grafts.…”

Section: Discussionmentioning

confidence: 90%

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Toia

Zabbia

Roggio

et al. 2017

J reconstr Microsurg

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Background The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (six flow-through flaps, one arterial graft), combined arterial and venous reconstruction in four cases (three vein grafts, one combined venous/arterial graft), and venous reconstruction in one case (one venous graft). The rate of complications and donor-site morbidity related to vascular graft harvest were evaluated. Results Reconstruction was successful in all cases, despite an overall complication rate of 17 and 8% of surgical revision. Donor-site morbidity, subjectively evaluated, was minimal with respect to functional deficits and aesthetic outcome. Indications for the different types of grafts are discussed. Conclusion The use of vascular grafts is needed in a relevant percentage of microsurgical reconstruction cases. Venous and arterial vascular grafts, transient arteriovenous fistulas, and “flow-through” microsurgical flaps showed a safe reconstruction comparable to microsurgical reconstructions without the use of grafts. Donor-site morbidity secondary to vascular graft harvest is minimal, and in almost 70% of cases no additional scars are needed.

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Section: Discussionmentioning

confidence: 90%

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Toia

Zabbia

Roggio

et al. 2017

J reconstr Microsurg

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“…In a patent population in whom both radial artery and SVG grafts were used for CABG, it was found that radial artery grafts fared worse than SVGs in patients with PAD [79].…”

Section: Impact Of Pad On Graft Failure In Cabgmentioning

confidence: 99%

Impact of Renal Dysfunction and Peripheral Arterial Disease on Post-Operative Outcomes After Coronary Artery Bypass Grafting

Chaudhry¹,

Omar²,

Latif³

2013

Artery Bypass

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Cockcroft-Gault equation: Creatinine Clearance (ml/min) = [([140 − age] × weight [kg])/72 × serum creatinine (mg/dl)] (× 0.85 for women), MDRD equation: GFR (mL/min/1.73 m 2) = 175 × (serum creatinine)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American) (conventional units) Creatinine clearance or glomerular filtration rate (GFR) represents renal function. Declining values represent a decline in renal function. Stage 1 refers to glomerular filtration rate (GFR) >90 ml/min and is generally asymptomatic. GFR between 60-90 ml/min is stage 2 CKD. Stage 3 is GFR between 30 and 60 ml/min and is further subdivided into Stage 3A (GFR 45-60 ml/min) and Stage 3B (GFR 30-45 ml/min). Stage 4 is defined by GFR between 15-30 ml/min while GFR <15 ml/min signifies Stage 5 and is considered an indication for renal replacement therapy i.e. dialysis. The most common etiological factors for CKD include diabetes mellitus and hypertension resulting in diabetic nephropathy and hypertensive nephrosclerosis, respectively.

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“…The occlusion of vein grafts occurs in approximately 15-20 % of patients in the first post-operative year, mainly due to neointimal hyperplasia, increasing to the occlusion of 20-30 % of grafted arteries 5 years later, mainly due to atherosclerosis [136,137]. The long-term benefit of CABG surgery is limited by the life expectancy of autologous saphenous vein grafts, which still represent the most widely used conduits.…”

Section: Gene Therapy Approach To Restenosismentioning

confidence: 99%

Novel potential targets for prevention of arterial restenosis: insights from the pre-clinical research

et al. 2014

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Restenosis is the pathophysiological process occurring in 10-15% of patients submitted to revascularization procedures of coronary, carotid and peripheral arteries. It can be considered as an excessive healing reaction of the vascular wall subjected to arterial/venous bypass graft interposition, endarterectomy or angioplasty. The advent of bare metal stents, drug-eluting stents and of the more recent drug-eluting balloons, have significantly reduced, but not eliminated, the incidence of restenosis, which remains a clinically relevant problem. Biomedical research in pre-clinical animal models of (re)stenosis, despite its limitations, has contributed enormously to the identification of processes involved in restenosis progression, going well beyond the initial dogma of a primarily proliferative disease. Although the main molecular and cellular mechanisms underlying restenosis have been well described, new signalling molecules and cell types controlling the progress of restenosis are continuously being discovered. In particular, microRNAs and vascular progenitor cells have recently been shown to play a key role in this pathophysiological process. In addition, the advanced highly sensitive high-throughput analyses of molecular alterations at the transcriptome, proteome and metabolome levels occurring in injured vessels in animal models of disease and in human specimens serve as a basis to identify novel potential therapeutic targets for restenosis. Molecular analyses are also contributing to the identification of reliable circulating biomarkers predictive of post-interventional restenosis in patients, which could be potentially helpful in the establishment of an early diagnosis and therapy. The present review summarizes the most recent and promising therapeutic strategies identified in experimental models of (re)stenosis and potentially translatable to patients subjected to revascularization procedures.

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Long-Term Patency Rate for Radial Artery vs. Saphenous Vein Grafts Using Same-Patient Materials

Cited by 21 publications

References 25 publications

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Impact of Renal Dysfunction and Peripheral Arterial Disease on Post-Operative Outcomes After Coronary Artery Bypass Grafting

Novel potential targets for prevention of arterial restenosis: insights from the pre-clinical research

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