scholarly journals Free radial artery as an alternate conduit in CABG

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Abdul Waheed ◽  
Ahmed Shabaz ◽  
Junaid Fayyaz Khan ◽  
Zafar Tufail
Keyword(s):  
Radial Artery ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Suitable Alternative ◽  
Graft Stenosis ◽  
Group A ◽  
Obtuse Marginal ◽  
Group B

Objective: This study was under taken to explore the potential of the Free Radial Graft as a safe efficient and suitable alternative conduit in coronary artery bypass grafting incase of in availability of the more established conduits like the IMA and Great Saphenous Vein graft especially in redo surgery. Method: This prospective randomized single center trial was conducted on three groups of patients under going CABG. The study was conducted from 1st January 1999 to December 2002.The first group A (n=15 with mean age of 47.05±8.35years) Radial artery was used for grafting in Right and Left sided grafts except the LAD. In the second group B (n=15 with a mean age of 54.80±11.14 years) Great Saphenous Vein was used for grafting in Right and Left sided grafts except the LAD. In the third group C (n=20 with a mean age of 55.93± 11.14 years) IMA was only grafted to LAD. Proximal ends of both the GSV and the Radial Artery were anastomosed to the Aorta. All patients were male . Follow up was done in these patien ts both by non invasive and invasive methods such as ETT , Thallium scan , Angiography. Comparison was mainly done between the Radial artery and the Great Saphenous Vein taking as granted that the IMA g the best graft for the LAD in all cases. Results: IMA was always applied to LAD in all patients in the three groups. In group (A) Radial Artery was grafted to RCA in 5 (33.3%) pts. Diagonal in 4 (26.7%)pts. Obtuse Marginal 12(80%) pts. And PDA 3 (20%) pts. In group (B) Great Saphenous Vein was grafted to RCA in 6(40%)pts. Circumflex 1(6.7%)pts. Diagonals 2 (13.3%) pts. Obtuse marginals 6 (40%) pts. And on PDA 4(20%) pts. All patients were regularly followed up for 18 months to 24 months. Post operative angina was reported in 2 (13.3%)pts. in group A and 5(33.3%) pts. In group B (p=0549). ETT was done in all these pts. Was positive in 1(6.7%) in group A and 2 (13.3%) in group B (p=0.309). Thallium scan was done in all the study population and was found positive in 4 (26.7%) in group A and 5 (33.3%) in group B Patients(p=0.265). Coronary angiograms were done on 10 patients out of each group. In group A the grafts were patent in 9 patients (90%). In the group B the grafts were found patent in 8 (86%) patients.(p=0.543). Moderate Graft stenosis was found in 01 patient in group B and none in group A (p=0.35). Totally blocked grafts were found in 01 patients in each group (p=1.00).

scholarly journals Quercetin Relieves the Excised Great Saphenous Vein Oxidative Damage and Inflammatory Reaction

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yunpeng Bai ◽  
Qingliang Chen ◽  
Xiaolong Zhu ◽  
Nan Jiang ◽  
Ximing Li ◽  
...  
Keyword(s):  
Oxidative Damage ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Life Quality ◽  
Mechanical Damage ◽  
Immunofluorescent Staining ◽  
Sod Activity

Objective. The patency and quality of transplanted great saphenous vein (GSV) can seriously influence the physical state and life quality of patients who accepted the coronary artery bypass grafting (CABG). Quercetin is known for antioxidant, antithrombotic, anti-inflammatory, and antitumor properties. In this study, we examined the protection of quercetin to the great saphenous vein from oxidative and inflammatory damage. Methods. The GSVs were collected from 15 patients undergoing CABG and cultured. Treated the veins by H2O2 and detected the NO, SOD, and MDA content by the relevant kits to explore the quercetin protection against oxidative damage. Then, for another group of GSVs, sheared them and detected the inflammatory cytokines, such as IL-6, TNFα, CCL20, PCNA, and VEGF. Collect the veins for H&E staining and PCNA and VEGF immunofluorescent staining. Results. Pretreatment by quercetin reduced the production of NO and MDA induced by H2O2, and increased SOD activity. Quercetin also supressed the mRNA expressions of IL-6, TNFα after mechanical damage and had no influence on CCL20 and VEGF. Consistent with the lower expression of PCNA treated by quercetin, the vein intima was thinner. Conclusion. These results demonstrated that quercetin protects GSVs by reducing the oxidative damage and inflammatory response and also suppresses the abnormal thickening of venous endothelium by inhibiting cell proliferation. It reminded that, to some extent, quercetin has the potential to release the great saphenous vein graft damage.

The impact of direction of great saphenous vein total stripping on saphenous nerve injury

2012 ◽  
Vol 29 (1) ◽  
pp. 52-57 ◽  
Author(s):  
J C Papakostas ◽  
E Douitsis ◽  
I Sarmas ◽  
S Avgos ◽  
A Kyritsis ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Signs ◽  
Saphenous Nerve ◽  
Electrophysiological Studies ◽  
Saphenous Nerve Injury ◽  
Group A ◽  
Group B ◽  
The Impact

Objectives To examine and compare the effects of downwards versus upwards total stripping of great saphenous vein (GSV) on saphenous nerve (SN) injury using clinical and electrophysiological studies. Methods Fifty patients with varicosities were equally and randomly assigned to undergo total, upwards stripping (group A) or downwards stripping (group B) of GSV during saphenectomy. SN function was measured with electroneurogram (ENG) before operation, two weeks and 12 weeks after, in order to record the incidence and type of SN injury. Clinical signs of SN injury were also recorded at the same time points. The results were statistically analysed. Results There were no statistical significant differences on the occurrence of SN injury between groups A and B at two and 12 weeks, respectively, as confirmed with ENG studies and clinical evaluation. There were no differences between the two techniques with regard to the type of SN injury. SN injury was significantly ameliorated from 34% to 6% during the first three months. Conclusion SN injury was equally observed after downwards or upwards total stripping of the GSV, as confirmed by ENG and clinical evaluation, with no differences in injury type. SN injury tends to be relieved through time in most patients.

Effects of eccentric compression by a crossed-tape technique after endovenous laser ablation of the great saphenous vein: a randomized study

2009 ◽  
Vol 24 (4) ◽  
pp. 151-156 ◽  
Author(s):  
M Lugli ◽  
A Cogo ◽  
S Guerzoni ◽  
A Petti ◽  
O Maleti
Keyword(s):  
Laser Ablation ◽  
Postoperative Pain ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Randomized Study ◽  
Endovenous Laser Ablation ◽  
Eccentric Compression ◽  
Experienced Pain ◽  
Group A ◽  
Group B

Objectives To evaluate the effect of eccentric compression applied by a new crossed-tape technique on procedure-related pain occurrence after endovenous laser ablation (ELA) of the great saphenous vein (GSV). Methods From April 2005 to June 2006, 200 consecutive ELA procedures were randomized to receive (group A: 100) or not (group B: 100) an eccentric compression applied in the medial aspect of the thigh. Patients were scheduled for a seven-day examination to assess the level of pain experienced. Pain intensity was measured using a visual analogue scale giving a numerical grade from 0 (no pain) to 10 (worst pain ever). Results The intensity of postoperative pain was significantly reduced ( P < 0.001) in the eccentric compression group as compared with the non-compression one. Conclusions This technique of eccentric compression greatly reduces the intensity of postoperative pain after ELA of the GSV.

scholarly journals Altered velocity gradient in lower limb chronic venous disease

2018 ◽  
Vol 34 (1) ◽  
pp. 17-24
Author(s):  
Sergio Gianesini ◽  
Francesco Sisini ◽  
Erica Menegatti ◽  
Giovanni Di Domenico ◽  
Mauro Gambaccini ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Velocity Gradient ◽  
Great Saphenous Vein ◽  
Venous Drainage ◽  
Chronic Venous Disease ◽  
Velocity Variation ◽  
Venous Disease ◽  
Group A ◽  
The One ◽  
Group B

Background In physiology, velocity of the deep venous compartment is higher than the one in the saphenous compartment which is higher than the one in the tributaries. Considering that velocity variation is associated with changes in the pressure gradient, aim of the present study is to assess changes in venous kinetics in case of superficial chronic venous disease, so to provide further clues in venous drainage direction determination. Methods Venous ultrasound scanning was performed on 40 lower limbs of 28 chronic venous disease patients (C2-6Ep,As,Pr). Velocities were measured in three different venous segments: great saphenous vein at 2 cm above the origin of the incompetent tributary (Group-A). great saphenous vein at 2 cm below the origin of tributary (Group-B). tributary at 2 cm from its origin from the great saphenous vein (Group-C.) Results Diastolic time average velocity was higher in group-C (−21.3 ± 8.5 cm/s) than in group-A (−15.7 ± 5.2 cm/s; p = .0001) and group-B (−11.1 ± 2.9 cm/s; p = .0001), thus indicating an inversion of the physiological velocity gradient in chronic venous disease patients. Discussion Chronic venous disease presents a subverted velocity gradient. These data introduce objective hemodynamics data, paving the way for further investigation in venous drainage direction determination.

scholarly journals Postoperative morbidity differences between proximal and distal knee saphenous harvesting in coronary artery bypass graft surgery

2021 ◽  
Vol 6 (2) ◽  
pp. 131-135
Author(s):  
Ismail Selçuk ◽  
◽  
Nehir Selçuk ◽  
Bülent Barış Güven
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Wound Complications ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Group A ◽  
Group B ◽  
Level Group

Objectives. Coronary artery bypass grafting (CABG) is the most common procedure in cardiac surgery and the great saphenous vein (GSV) are the preferred conduits. The effects of saphenous vein incision (SVI) harvesting site choice on SVI wound complications, pretibial edema, and the need for compression stockings were evaluated retrospectively in patients undergoing CABG surgery. Materials and Methods. A total of 1900 patients operated for CABG between 2003 and 2021 in our clinic were included in this study, with GSV harvest performed at below-knee level (Group-A, n:841) and above-knee level (Group-B, n:1059). SVI was made 2 cm superior and 1 cm anterior to the medial malleolus in group-A; and 3 cm superior to medial epicondyle, extending to 3 cm inferior to the inguinal ligament in group-B. Examination for edema was made with 4-5 seconds of thumb pressure at the ankle level, then the depth of the pit was measured. Results. Ankle edema (Group-A n:132, Group-B n:25), the use of compression stockings (Group-A n:97, Group-B n:13), and paresthesia (Group-A n:51, Group-B n:10) were different between the two groups and the differences were statistically significant. However, prolonged wound healing (Group-A n:11, Group-B n:38), superficial wound infection (Group-A n:6, Group-B n:11), hematoma (Group-A n:4, Group-B n:9), and lymphorrhea (Group-A n:4, Group-B n:7) incidences were not statistically different between the two groups. Conclusions. Among patients with GSV extracted using the open conventional surgery technique, pretibial edema, paresthesia, and compression stocking use were observed less frequently in patients with preoperative doppler-ultrasonography evaluation and above-knee saphenous harvest.

scholarly journals The outcome of the Trendelenburg procedure with stripping vs. no stripping in the management of varicose veins

2020 ◽  
Vol 14 (03) ◽  
pp. 110-113
Author(s):  
Jibran Mohsin ◽  
Muhammad Haris Janjua ◽  
Jumana Fatima ◽  
Muhammad Usman Siddique ◽  
Muhammad Yasir Naseem ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Controlled Trial ◽  
Treatment Options ◽  
P Value ◽  
Chi Square ◽  
Group A ◽  
Group B

Background: Varicose veins is a common problem in Pakistan with multiple treatment options. One of its recommended and commonly performed surgical treatment includes the flush ligation of Saphenofemoral junction (Trendelenburg procedure) with stripping of great saphenous vein and avulsion of varicosities which is a cumbersome process. This study aims to evaluate the effect of stripping of great saphenous vein on the recurrence rate. Patients and methods: A randomized controlled trial was conducted in the Surgical Unit I, Services Hospital, Lahore over a period of 22 months from 20-09-2016 to 20-07-2018. Seventy patients were divided equally into two groups of 35 patients each i.e. Trendelenbrug procedure and avulsion of varicosities with stripping down to the knee, (Group A) versus Trendelenbrug procedure and avulsion of varicosities without stripping (Group B). Recurrence at 12 weeks was noted. SPSS version 17.0 was used to analyze data. Comparison of recurrence and stratified confounding factors such as age, gender, and BMI were assessed by the chi-square test (significant p-valve ≤0.05). Results: In group A, 32 out of 35 patients were male (91.43%) and 3 (8.57%) were female. While in group B, 31 out of 35 patients were male (88.87%) and 4 (11.43%) were female. Four out of 35 (11.43%) patients in group A whereas 6 (17.14%) group B patients (p-value=0.494) had a recurrence in the perforators below the knee at 12 weeks. Stratification (p-values) of recurrence rate with respect to age (<40 years: 0.41 versus ≥ 40 years:0.905), gender (female: p-value not applicable versus male: 0.96) and BMI was done (<25 kg/m2: 0.36 versus ≥ 25 kg/m2: 0.901) Conclusions: Stripping does not significantly affect the outcome of varicose vein surgery in relation to the recurrence rate at 12 weeks and recurrence was independent of age, gender, and BMI of patients.

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