No-Touch Saphenous Vein Harvesting May Improve Further the Patency of Saphenous Vein Composite Grafts: Early Outcomes and 1-Year Angiographic Results

Kim, Yong Han; Oh, Hong Chul; Choi, Jae Woong; Hwang, Ho Young; Kim, Ki Bong

doi:10.1016/j.athoracsur.2016.09.024

Cited by 70 publications

(65 citation statements)

References 16 publications

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“…This technique associated with nonabove‐arterial pressure distention has demonstrated in some studies to provide substantially better long‐term outcomes in terms of vein graft patency. However, it has the disadvantage of being associated with a higher incidence of graft site complications in the early postoperative period 38‐42 Vein preservation media: The choice of preservation media during storage of the LSV prior to its use has been associated with increased concentration of free oxygen radicals and ischemia in all layers of the vein 43 .…”

Section: Resultsmentioning

confidence: 99%

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Saphenous vein graft disease, pathophysiology, prevention, and treatment. A review of the literature

et al. 2020

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Background The saphenous vein remains the most frequently used conduit for coronary artery bypass grafting, despite reported unsatisfactory long‐term patency rates. Understanding the pathophysiology of vein graft failure and attempting to improve its longevity has been a significant area of research for more than three decades. This article aims to review the current understanding of the pathophysiology and potential new intervention strategies. Methods A search of three databases: MEDLINE, Web of Science, and Cochrane Library, was undertaken for the terms “pathophysiology,” “prevention,” and “treatment” plus the term “vein graft failure.” Results Saphenous graft failure is commonly the consequence of four different pathophysiological mechanisms, early acute thrombosis, vascular inflammation, intimal hyperplasia, and late accelerated atherosclerosis. Different methods have been proposed to inhibit or attenuate these pathological processes including modified surgical technique, topical pretreatment, external graft support, and postoperative pharmacological interventions. Once graft failure occurs, the available treatments are either surgical reintervention, angioplasty, or conservative medical management reserved for patients not eligible for either procedure. Conclusion Despite the extensive amount of research performed, the pathophysiology of saphenous vein graft is still not completely understood. Surgical and pharmacological interventions have improved early patency and different strategies for prevention seem to offer some hope in improving long‐term patency.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Saphenous vein graft disease, pathophysiology, prevention, and treatment. A review of the literature

et al. 2020

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“…In response to the structural and functional limitations associated with saphenous vein grafting, composite grafts based on the in‐situ LIMA have been investigated as an alternative to improve conduit patency . The study, as conducted by Kim et al, identified that SV grafts harvested with an NT technique further improved the early and 1‐year patency of SV composite grafts as harvested using minimal manipulation techniques.…”

Section: The No‐touch Techniquementioning

confidence: 99%

“…A minimally manipulative surgical strategy in harvesting the SV for use in a Y‐composite graft based on the LIMA has been shown to preserve endothelial structure when compared with manual dilatation of harvested dilated SV . The theoretical advantages of using the SV as part of a composite graft include less exposure to pressure trauma from the ascending aorta and reduced propensity for atherosclerotic progression due to the constant exposure of nitric oxide produced by the LIMA . Further efforts to improve patency of the SV continue to be trialed; of which external stent support and intraoperative gene therapy represent two examples .…”

Section: The No‐touch 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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“…4,7 A higher incidence of vein harvest site complications has been seen with the NT-SVG compared with conventional SVGs 4 and endoscopic SVGs in an observational study. 9 Two studies 10,11 reported a skip incision technique of NT-SVG; however, additional studies are required, including the feasibility of this technique, incidence of wound complications, and impact on graft patency and clinical outcomes.…”

mentioning

confidence: 99%

Reply from the authors: The race for the second best…continues—The no-touch saphenous vein versus the radial artery

Deb

Fremes

2020

The Journal of Thoracic and Cardiovascular Surgery

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We thank Dashwood and colleagues 1 for their reply to our commentary regarding the use of the radial artery (RA) and no-touch saphenous vein graft (NT-SVG) in patients undergoing coronary artery bypass grafting surgery. 2 Our commentary was predicated on the recently published 8-year patency results of a single-center randomized controlled trial comparing the RA with the NT-SVG by Dreifaldt and colleagues. 3 We agree that NT-SVG has excellent potential as

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No-Touch Saphenous Vein Harvesting May Improve Further the Patency of Saphenous Vein Composite Grafts: Early Outcomes and 1-Year Angiographic Results

Abstract: The SV grafts harvested with a no-touch technique further improved the early and 1-year patency of SV composite grafts. Midterm and long-term angiographic follow-up may be warranted to demonstrate the superiority of no-touch SV composite grafts.

Cited by 70 publications

References 16 publications

Saphenous vein graft disease, pathophysiology, prevention, and treatment. A review of the literature

Saphenous vein graft disease, pathophysiology, prevention, and treatment. A review of the literature

Long saphenous vein harvesting techniques and their effect on graft patency

Reply from the authors: The race for the second best…continues—The no-touch saphenous vein versus the radial artery

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