scholarly journals Saphenous vein graft aneurysm with graft-enteric fistula after renal artery bypass

2008 ◽  
Vol 48 (3) ◽  
pp. 738-740 ◽  
Author(s):  
Mark M. Levy ◽  
William Kiang ◽  
Jason M. Johnson ◽  
Stuart I. Myers
Keyword(s):  
Renal Artery ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Enteric Fistula

scholarly journals Hemoptysis caused by saphenous vein graft aneurysm late after coronary artery bypass grafting

2005 ◽  
Vol 129 (6) ◽  
pp. 1432-1433 ◽  
Author(s):  
Yoshiharu Nishimura ◽  
Yoshitaka Okamura ◽  
Takeshi Hiramatsu ◽  
Hideaki Mori ◽  
Hiroki Hayashi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

scholarly journals Saphenous Vein Graft Disease Interventions

2021 ◽  
Vol 06 (03) ◽  
pp. 199-208
Author(s):  
Sarita Rao ◽  
K. Roshan Rao ◽  
Achukatla Kumar
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Left Internal Mammary Artery ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Standard Of Care ◽  
Coronary Intervention ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vein Grafts

AbstractIn the current era, coronary artery bypass grafting (CABG) is being increasingly performed using total arterial revascularization or a hybrid procedure of stenting of non-LAD disease and minimal access left internal mammary artery (LIMA) to LAD grafts, in order to minimize the need for vein grafts. Still, we encounter saphenous vein graft (SVG) disease, and it might require PCI, which often presents with unique challenges. The current favored strategy is to attempt PCI of the native coronary, if feasible, especially in long degenerated SVG disease, as it has shown better short- and long-term outcome. PCI is preferred over repeat CABG for early recurrent symptoms after CABG in patent LIMA graft and amenable anatomy patients. Balloon predilatation is not recommended unless delivery of an EPD or stent is not possible. Distal protection should be considered the standard of care for percutaneous coronary intervention (PCI) in most patients with older vein grafts, as periprocedural myocardial infarction and no reflow are the Achilles heel of SVG PCI. Intragraft vasodilators should be used liberally, even before balloon angioplasty/stenting. Avoid postdilatation, and usage of undersized but a longer stent length to reduce plaque extrusion through stent struts is preferred. Consider thrombectomy in lesions with a heavy thrombus burden. Keep activated clotting time on the higher side than in conventional PCI. Prolonged dual antiplatelet therapy (DAPT) based on the DAPT score is recommended. With all the precautions and care, we still need a fair wind in our favor to sail through the vein grafts disease.

scholarly journals Preserving the Endothelium in Saphenous Vein Graft with Both Conventional and No-touch Preparation

2020 ◽  
Author(s):  
Toshiro Saito ◽  
Hiroshi Kurazumi ◽  
Ryo Suzuki ◽  
Yutaro Matsuno ◽  
Akihito Mikamo ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Vascular Wall ◽  
Ultrastructural Level ◽  
Arterial Grafts ◽  
Endothelial Surface ◽  
Endothelial Integrity ◽  
Von Willebrand

Abstract Background Despite the inferior patency compared to arterial grafts, a saphenous vein graft (SVG) is widely used for coronary artery bypass grafting (CABG). A lower atherosclerosis rate and higher patency have been reported for SVG obtained via the no-touch technique (NT) than via conventional preparation (CV). Although CV-mediated endothelial dysfunction is implied, the precise mechanism underlying the higher patency with NT is poorly understood. Methods Human residual SVGs during CABG and SVG sections after autopsy were analyzed. The endothelial surface was observed using scanning electron microscopy (SEM) and blindly compared between CV and NT. The endothelial integrity was also analyzed with immunohistochemistry.Results Unexpectedly, the hyperfine structure on SEM was comparable between CV and NT before grafting, and microvillus, a characteristic of endothelium, was indistinguishable between them. von Willebrand Factor, an endothelial marker, was equally detected throughout the vascular wall in both groups from residual and postmortem sections.Conclusions The morphological integrity of the endothelium was successfully preserved in SVG with CV, even at an ultrastructural level. Although its functionality remains to be addressed, other factors than the endothelium may be involved in the high patency obtained by NT. The present findings suggest that the characteristics of NT and surgical methodology should be reconsidered.

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