The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

Samano, Ninos; Geijer, Håkan; Lidén, Mats; Fremes, Stephen E.; Bodin, Lennart; Souza, Domingos

doi:10.1016/j.jtcvs.2015.07.027

Cited by 239 publications

(212 citation statements)

References 33 publications

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“…They concluded that harvesting SVG with surrounding tissue provided excellent short-and long-term patency, which was comparable to the IMA [75].…”

Section: Cabg Using Saphenous Vein Graftsmentioning

confidence: 87%

The Choice of Graft Conduits in Coronary Artery Bypass Grafting

Murashita¹

2017

Coronary Artery Bypass Graft Surgery

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The use of the left internal mammary artery (IMA) has been shown to improve longterm survival and has been a gold standard in coronary artery bypass grafting (CABG). However, the choice of second or third graft conduit is still controversial. Multiple studies demonstrated the beneit of using multiple arterial grafts such as right IMA and radial artery in addition to left IMA in terms of long-term survival and graft patency. However, most of the centers still perform CABG with one IMA and vein grafts in a real world. The challenges for bilateral IMA utilization include longer operative time and concerns for higher rates of perioperative morbidity and mortality associated with increased sternal wound infection. Several studies reported that skeletonization technique can reduce the risk of sternal wound infection. Radial artery is another arterial conduit, which does not increase the risk of sternal wound infection and is easy to harvest. The superiority between radial artery and right IMA has been controversial. In the meantime, multiple trials have been made to improve the patency of vein grafts. The choice of graft conduits in CABG should be well considered preoperatively based on each patient's backgrounds.

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“…They concluded that harvesting SVG with surrounding tissue provided excellent short-and long-term patency, which was comparable to the IMA [75].…”

Section: Cabg Using Saphenous Vein Graftsmentioning

confidence: 87%

The Choice of Graft Conduits in Coronary Artery Bypass Grafting

Murashita¹

2017

Coronary Artery Bypass Graft Surgery

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“…A final drawback of the study could have resulted from the conventional technique of harvesting the vein grafts in this study opposed to the no-touch technique that has been recommended by some groups, because it provided a significantly higher patency [24] and left ventricular ejection fraction [25] at a mean time of 16 years than the conventional technique.…”

Section: Study Limitationsmentioning

confidence: 97%

Function and Viability of Vessels in Different Preservation Solutions - An Experimental Study on Human Great Saphenous Veins

Schipke¹

2016

AVS

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ObjectiveGreat Saphenous Veins (SVs) are widely used in coronary and in non-coronary surgery, and the need for vascular transplants is increasing. In older pre¬servation solutions, hypothermia leads to damage induced by reactive oxygen species. Iron chelators in the newer Tissue Protection (TiProtec) solution shall par¬ticularly protect vessels by preventing from that damage.It was the aim to compare three preservation solutions to maintain function and viability of human SVs. MethodsVein segments were randomly assigned to Krebs-Henseleit Buffer (KHB), Viaspan (UW), or TiProtec. Contraction/relaxation in organ baths was assessed at 3, 24, 48 and 72h after removal. The protocol included three steps: receptor-independent contraction (KCl: 80μM), receptor-dependent contraction (PE: ≤30μM), endothelium-dependent relaxation (ACh: ≤20μM). Morphology: Vein segments were incubated with propidium iodide and 5-chloromethylfluorescein diacetate. Viability was assessed with fluorescence using laser scanning microscopy. ResultsKHB was inappropriate after only 3h. In TiProtec, SVs contraction/relaxation had increased further at 72h, but not in both other groups. More necrosis was found in KHB SVs than in UW or TiProtec at 3h. More viable cells were found in UW and in TiProtec SVs on day-1, while only few cells were viable in KHB on day-10. Summary and conclusionEven short storage of SVs in KHB is deleterious. UW preserved func¬tion better over time. The best functional and morphological results yielded TiProtec over time, and the amount of viable cells correlated with function. TiProtec seems a promising alternative for short-and mid-term hypothermic vein preservation.

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“…9) Permeability rates using this procedure are of 83% at 16 years compared to an 88% in arterial grafts. 9) Regarding the morphology of the SV, a Turkish study reported a mean length of 72.42 ± 6.60 cm. 20) The luminal diameter varies in proximal, medial, and distal segment itself, thus avoiding distension prior to anastomosis, 31,32) which can cause intimal and medial hyperplasia, leading to graft failure.…”

Section: Coronary Arteriesmentioning

confidence: 99%

“…In order to achieve this, it is necessary to complete the revascularization using ducts that will remain permeable for all or most of the patient's life. 4,9) There is a wide variety of vascular conduits available for CABG. The most commonly used are as follows: internal thoracic artery (ITA), saphenous vein (SV), radial artery (RA), right gastroepiploic artery (RGEA), and occasionally ulnar artery (UA), splenic artery, and inferior epigastric artery.…”

mentioning

confidence: 99%

Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies

Martínez-González

Reyes-Hernández

Quiroga‐Garza

et al. 2017

ATCS

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The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

Abstract: Harvesting the SV with the NT technique conferred, at a mean time of 16 years, a significantly higher patency than the conventional technique that was still comparable to that of the LITA.

Cited by 239 publications

References 33 publications

The Choice of Graft Conduits in Coronary Artery Bypass Grafting

The Choice of Graft Conduits in Coronary Artery Bypass Grafting

Function and Viability of Vessels in Different Preservation Solutions - An Experimental Study on Human Great Saphenous Veins

Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies

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