Coagulation Factor V (Arg506 → Gln) Mutation and Early Saphenous Vein Graft Occlusion after Coronary Artery Bypass Grafting

1998 ◽  
Vol 80 (08) ◽  
pp. 220-224 ◽  
Author(s):  
Angela Silveira ◽  
Hooft Ferdinand van’t ◽  
Per Tornvall ◽  
Margareta Blombäck ◽  
Björn Wiman ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Factor V ◽  
Graft Occlusion ◽  
Vein Grafts ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryThe factor V (Arg506→Gln) mutation confers an increased risk of deep vein thrombosis, whereas its role in saphenous vein graft closure after coronary artery bypass grafting (CABG) remains unclear. This study examined the anticoagulant response to activated protein C (APC ratio) in relation to the surgical trauma and the significance of the factor V Leiden mutation in determining postoperative thrombin generation and fibrin formation and the risk of early vein graft occlusion. A total of 108 men undergoing elective CABG for exertional angina pectoris (mean age 61.1 ± 8.7 years) were examined. The patency of saphenous vein grafts was studied at routine reangiography three months after CABG.Of 100 patients who underwent reangiography, 23 had one or more occluded vein grafts at reangiography. Heterozygosity for the factor V (Arg506→Gln) mutation tended to be associated with early saphenous vein graft occlusion (5/11 carriers vs. 18/89 non-carriers with graft occlusion, व2 = 3.52, p = 0.06), whereas pre- and postoperative APC ratios did not. Pre- and postoperative determinations of prothrombin fragment 1+2, thrombin-antithrombin complexes and soluble fibrin levels did not differ between patients with and without the mutation.Early saphenous vein graft occlusion after CABG could tentatively be added to deep vein thrombosis as a vascular complication that can be attributed to the factor V (Arg506→Gln) mutation.

scholarly journals Preoperative factors predicting saphenous vein graft occlusion in coronary artery bypass grafting: a multivariate analysis

2017 ◽  
Vol 148 (4) ◽  
pp. 417-424 ◽  
Author(s):  
Agnieszka Malinska ◽  
Zuzanna Podemska ◽  
Bartlomiej Perek ◽  
Marek Jemielity ◽  
Piotr Buczkowski ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Graft Occlusion ◽  
Preoperative Factors

scholarly journals Adropin: A New Marker for Predicting Late Saphenous Vein Graft Disease after Coronary Artery Bypass Grafting

2014 ◽  
Vol 37 (5) ◽  
pp. 338 ◽  
Author(s):  
Bora Demircelik ◽  
Muzaffer Cakmak ◽  
Yunus Nazli ◽  
Ozgul M Gurel ◽  
Nermin Akkaya ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Graft Occlusion ◽  
Vein Graft Disease ◽  
Graft Disease ◽  
Saphenous Vein Graft Disease

Purpose: Saphenous vein graft disease (SVGD), defined as an occlusion of 50% or more of the SVG excluding distal anastomotic occlusion, is an important predictor of morbidity after coronary artery bypass grafting (CABG). Late graft occlusion is a serious complication that often limits the use of the saphenous vein as a coronary bypass graft. Late graft occlusion is particularly common in old, degenerated venous grafts with advanced atherosclerotic plaques. Adropin has been implicated in the homeostatic control of metabolism. The purpose of this study was to investigate whether serum adropin levels are associated with late SVGD following CABG. Methods: Thirty-eight patients with SVGD involving at least one graft (occluded group; 14 females, 24 males) and 42 patients with a patent saphenous vein graft (patent group; 15 females, 27 males) were enrolled in this study. Venous blood samples were taken from all of the participants to measure plasma adropin levels using an enzyme-linked immunsorbent assay kit. Results: The mean adropin level was significantly lower in the occluded group than in the patent group (3.2 ± 0.71 vs. 4.9 ± 1.51 ng/mL, p < 0.001). Multivariate regression analysis showed that the adropin level was the independent predictor of late saphenous vein graft occlusion. Conclusions: Adropin levels are lower in patients with late saphenous vein graft occlusion and these reduced adropin levels, together with other factors, may lead to saphenous vein graft occlusion. Larger and prospective studies are needed to determine if adropin plays a role in the pathogenesis of SVGD.

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.

Comparison of propaten heparin-bonded vascular graft with distal anastomotic patch versus autogenous saphenous vein graft in tibial artery bypass

Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Jeremy Kaisar ◽  
Aaron Chen ◽  
Mathew Cheung ◽  
Elias Kfoury ◽  
Carlos F Bechara ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Length Of Hospital Stay ◽  
Primary Patency ◽  
Secondary Patency ◽  
Graft Occlusion ◽  
Tibial Artery

Introduction Heparin-bonded expanded polytetrafluoroethylene grafts (Propaten, WL Gore, Flagstaff, AZ, USA) have been shown to have superior patency compared to standard prosthetic grafts in leg bypass. This study analyzed the outcomes of Propaten grafts with distal anastomotic patch versus autogenous saphenous vein grafts in tibial artery bypass. Methods A retrospective analysis of prospective collected data was performed during a recent 15-year period. Sixty-two Propaten bypass grafts with distal anastomotic patch (Propaten group) were compared with 46 saphenous vein graft (vein group). Pertinent clinical variables including graft patency and limb salvage were analyzed. Results Both groups had similar clinical risk factors, bypass indications, and target vessel for tibial artery anastomoses. Decreased trends of operative time (196 ± 34 min vs. 287 ± 65 min, p = 0.07) and length of hospital stay (5.2 ± 2.3 days vs. 7.5 ± 3.6, p = 0.08) were noted in the Propaten group compared to the vein group. Similar primary patency rates were noted at four years between the Propaten and vein groups (85%, 71%, 64%, and 57%, vs. 87%, 78%, 67%, and 61% respectively; p = 0.97). Both groups had comparable secondary patency rates yearly in four years (the Propaten group: 84%, 76%, 74%, and 67%, respectively; the vein group: 88%, 79%, 76%, and 72%, respectively; p = 0.94). The limb salvage rates were equivalent between the Propaten and vein group at four years (84% vs. 92%, p = 0.89). Multivariate analysis showed active tobacco usage and poor run-off score as predictors for graft occlusion. Conclusions Propaten grafts with distal anastomotic patch have similar clinical outcomes compared to the saphenous vein graft in tibial artery bypass. Our data support the use of Propaten graft with distal anastomotic patch as a viable conduit of choice in patients undergoing tibial artery bypass.

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