The no-touch saphenous vein graft in elderly coronary bypass patients with multiple comorbidities is a promising conduit to substitute the left internal thoracic artery

Samano, Ninos; Geijer, Håkan; Bodin, Lennart; Arbeus, Mikael; Mannion, John D.; Dashwood, Michael R.; Souza, Domingos

doi:10.1016/j.jtcvs.2017.03.048

Cited by 24 publications

(21 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Subsequently, a randomized trial comparing C SVG and NT SVG has shown that the latter is superior in terms of patency rates and left ventricular ejection fraction at 1.5, 8.5, and 16 years postoperatively [15][16][17][18] , as seen in Table 1 from Samano et al [17] , 2015. Furthermore, NT SVGs exhibit a patency comparable to that of LITA at up to 16 years [16,17,19] , as seen in Figure 1 from Samano et al [17] , 2015.…”

Section: Saphenous Vein Structure and Vascular Damagementioning

confidence: 77%

Twenty-Five Years of No-Touch Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: Structural Observations and Impact on Graft Performance

Samano¹,

Souza²,

Pinheiro³

et al. 2020

Braz J Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

The saphenous vein is the most common conduit used in coronary artery bypass grafting (CABG) yet its failure rate is higher compared to arterial grafts. An improvement in saphenous vein graft performance is therefore a major priority in CABG. No-touch harvesting of the saphenous vein is one of the few interventions that has shown improved patency rates, comparable to that of the left internal thoracic artery. After more than two decades of no-touch research, this technique is now recognized as a Class IIa recommendation in the 2018 European Society of Cardiology and the European Association for Cardio-Thoracic Surgery guidelines on myocardial revascularization. In this review, we describe the structural alterations that occur in conventional versus no-touch saphenous vein grafts and how these changes affect graft patency. In addition, we discuss various strategies aimed at repairing saphenous vein grafts prepared at conventional CABG.

show abstract

Section: Saphenous Vein Structure and Vascular Damagementioning

confidence: 77%

Twenty-Five Years of No-Touch Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: Structural Observations and Impact on Graft Performance

Samano¹,

Souza²,

Pinheiro³

et al. 2020

Braz J Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…The no-touch technique in harvesting the saphenous vein consists of several steps in order to get a good quality conduit as well as to reduce leg wound complications (Video 1). Previous studies have shown a superior patency for the no-touch vein grafts in both the short- and long-term [1-4] .…”

Section: Surgical Techniquementioning

confidence: 99%

Surgical Aspects of No-Touch Saphenous Vein Graft Harvesting in CABG: Clinical and Angiographic Follow-Up at 3 Months

Samano¹,

Pinheiro²,

Souza³

2019

Braz J Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

With more than 800,000 coronary artery bypass grafting (CABG) operations annually worldwide and the saphenous vein being the most common conduit used, there is no question that improving saphenous vein graft patency is one of the most important tasks in CABG. This video describes the no-touch harvesting procedure of the saphenous vein on an 80-year old man with hypertension, hyperlipidemia and a previous myocardial infarction with percutaneous coronary intervention to the right coronary artery. He was complaining of exertional chest pain and was diagnosed with stable angina pectoris. The coronary angiography showed advanced three vessel disease with significant stenoses in the left anterior descending (LAD) artery, two marginal arteries (MAs) and the posterior descending artery (PDA), in addition to an occluded diagonal artery (DA). The patient received a triple sequential no-touch vein graft to the PDA and two MAs together with a double sequential no-touch vein graft to the DA and LAD. A vein graft was used to bypass the LAD due to the age of the patient and the low degree of stenosis in the LAD. The no-touch harvesting technique is described in detail in the film with complete narration. A follow-up of this patient was performed at three months both clinically and with a computed tomography angiography (CTA). No angina pectoris symptoms were reported by the patient and the wounds in the chest and lower limb were completely healed. The CTA showed patent no-touch saphenous vein grafts to all the distal anastomoses.

show abstract

“…This technique has been shown to reduce the risk of spasm and the need for distension (23) and consequently, preserves vessel wall integrity (20). This technique provides a superior patency rate (25)(26)(27)(28), preserved left ventricular function (29), and a better clinical outcome (30) compared to conventional harvesting, in both the short and the long term.…”

Section: No-touch (Nt) Harvesting Techniquementioning

confidence: 99%

No-touch vein grafts and the destiny of venous revascularization in coronary artery bypass grafting—a 25th anniversary perspective

Samano

Dashwood

Souza

2018

Ann. Cardiothorac. Surg.

Self Cite

View full text Add to dashboard Cite

Ischemic heart disease is currently the leading cause of death globally, with coronary artery bypass grafting among the most common operations performed worldwide. More extensive use of arterial grafts has been advocated because of their high long-term patency, long-term survival benefit, and freedom from reinterventions. Despite this, the saphenous vein is the most frequently used conduit in patients undergoing coronary artery bypass surgery since its introduction over 50 years ago. Consequently, the saphenous vein remains an indispensable conduit in coronary artery bypass grafting and maintaining its long-term patency is one of the most crucial challenges in cardiovascular surgery. This situation led to the development of the no-touch saphenous vein harvesting technique, where the vein is harvested completely with its pedicle of surrounding tissue. Several studies report a superior long-term patency rate, slower progression of atherosclerosis, and better clinical outcomes whilst employing no-touch harvesting technique. The success of the technique is multifactorial, including the decreased risk for graft spasm-and the need for manual distension-preservation of the vaso vasorum and an intact endothelium, reducing neointimal hyperplasia and subsequent atherosclerosis. Furthermore, the intact perivascular tissue, including the surrounding cushion of fat, may act as a "natural external stent", providing mechanical support preventing the graft from kinking. We are convinced that the use of arterial grafts, in combination with the no-touch saphenous vein graft, will significantly improve the results of coronary artery bypass grafting. This is important for achieving a comprehensive and evidence-based balance between the major treatment strategies of ischemic heart disease, explicitly coronary artery bypass grafting and percutaneous coronary intervention. The no-touch technique is becoming increasingly popular among surgeons, with further studies to be initiated worldwide.

show abstract

The no-touch saphenous vein graft in elderly coronary bypass patients with multiple comorbidities is a promising conduit to substitute the left internal thoracic artery

Abstract: In elderly coronary bypass patients with multiple comorbidities, a no-touch saphenous vein graft is a promising substitute for the left internal thoracic artery.

Cited by 24 publications

References 43 publications

Twenty-Five Years of No-Touch Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: Structural Observations and Impact on Graft Performance

Twenty-Five Years of No-Touch Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: Structural Observations and Impact on Graft Performance

Surgical Aspects of No-Touch Saphenous Vein Graft Harvesting in CABG: Clinical and Angiographic Follow-Up at 3 Months

No-touch vein grafts and the destiny of venous revascularization in coronary artery bypass grafting—a 25th anniversary perspective

Contact Info

Product

Resources

About