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Fifteen Years of ‘No-Touch’ Saphenous Vein Harvesting in Patients Undergoing Coronary Artery Bypass Surgery: What Have We Learned?

  • Michael R. Dashwood
  • Domingos S. R. Souza
Chapter

Abstract

Coronary artery disease (CAD) is the major cause of mortality in the Western world. Methods for restoring blood supply to the heart have changed over the years and include percutaneous transluminal coronary angioplasty (PTCA), bare metal or drug-eluting stents, with more recent attempts using techniques such as gene targeting and stem cell therapy. Once these techniques have failed, the remaining method for revascularization of the myocardium is coronary artery bypass surgery (CABG) using autologous blood vessel grafts as ‘conduits,’ restoring blood supply to diseased heart muscle. The main vessels used include the internal thoracic artery (ITA), radial artery (RA), and saphenous vein (SV). The success of CABG relies on the long-term patency of the conduit used for revascularization. Originally, SV grafts were used, but the ITA has subsequently become the first conduit of choice since it has superior patency compared with SV grafts [1, 2]. The poor long-term results with SV grafts and the encouraging results with ITA have led to a search for other arterial conduits for CABG. Among arterial grafts, the radial artery (RA) has gained the widest popularity as in many studies it has shown an excellent long-term patency [3] compared to SV grafts. However, recent studies have shown no difference between RA and SV grafts regarding their clinical outcome [4] or patency [5]. There is no doubt that the SV remains an important and the most widely used complementary conduit for patients undergoing CABG, and improvement of its long-term patency has been a major goal.

Keywords

Saphenous Vein Vein Graft Saphenous Vein Graft Internal Thoracic Artery Endoscopic Vein Harvesting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of Clinical BiochemistryRoyal Free and University College Medical SchoolLondonUK
  2. 2.Department of Cardiovascular Surgery and AnesthesiologyÖrebro University HospitalÖrebroSweden

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