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Showing 2 results for Saphenous Vein
Histological and biochemical characteristics of arteries and veins in patients candidate for coronary bypass surgery
Nasim Dana , Shiva Safavi , Nafiseh Nili , Badrodin Ebrahim Seyed Tabatabaei, Shaghayegh Haghjooy Javanmard ,
Volume 72, Issue 6 (9-2014)
Abstract
Background: The occlusion of the artery and vein grafts are currently a major problem in coronary bypass surgery. Degradation of collagen and elastin, the most abundant extracellular matrix proteins in the vessel wall by matrix metalloproteinase (MMPs), leads to a rearrangement of the extracellular matrix and vascular wall structure. The present study aimed to compare the histological and biochemical characteristics of arteries and veins which could have a role in the failure of the graft. Methods: This study was a cross-sectional study of 80 patients conducted at Heart Hospitals in Isfahan, Iran, between July 2012 and November 2013. Samples were collected from the remains of vessels used in bypass surgery of 11 male nondiabetic patients. The histologic, collagen elastin ratio and MMPs levels of the vessels were investigated. MMPs were determined using the Gelatin Zymography method. For elastin and collagen content measurement, the sample was digested by cyanogen bromide and hydrochloric acid and then hydroxyproline was measured with a spectrophotometer. Results: The amount of active and inactive MMP-2 and MMP-9 of the left internal mammary artery (Lima) was similar to aorta, but the amount of MMP-2 and MMP-9 in the radial artery and saphenous vein were significantly higher than aorta. Elastin to collagen ratio in Lima (1.92±1.15) was similar to the aorta (3.4±1.66), but this proportion in saphenous vein (1.07±0.47) and radial artery (1.14±0.39) was significantly lower in the aorta (P≤0.05). Most patients had atherosclerotic plaque in radial while there was atherosclerotic plaque in Lima of only one case. Conclusion: The presence of atherosclerotic plaques in radial and thickening of the intimal layer of the saphenous vein in the majority of patients and decrease of collagen to elastin ratio and the high level of matrix metalloproteinase enzymes in the radial and saphenous vein can induce early pathological conditions, and remodeling of the vessels involved. So the results of this study confirm that Left Internal Mammary Artery (LIMA) is the most suitable candidate for bypass surgery.
Comparison of therapeutic results of large saphenous vein resection with conventional methods and standard bridging
Iraj Nazari, Seyed Massoud Mousavi, Hossein Minaei Turk , Davoud Fateminia,
Volume 80, Issue 2 (5-2022)
Abstract

                                                                
Background: The use of the traditional method for saphenous vein harvesting is associated with wound complications and not on-time patient mobilization. This has caused the improvement of minimally invasive vein harvesting techniques, together with general bridging. This study was designed to compare the therapeutic results of large saphenous vein harvesting with conventional and standard bridging techniques for lower extremity vascular reconstruction in patients with chronic lower extremity ischemia.
Methods: In this randomized clinical trial study, 66 patients with chronic lower extremity ischemia were randomly divided into two groups: large saphenous vein harvesting by conventional technique (continuous longitudinal incision) (n=30) and standard Bridging technique (small and multiple incisions) (n=36). Pain score (VAS), graft patency, wound complications, surgery results and patient satisfaction was recorded. The follow-up period was six months. (IRCT20190511043562N1).
Results: Graft patency (P=0.353), and Amputation-free Survival (P=0.397) did not show a significant difference between the two groups. Changes in pain score at rest (P=0.846) and movement (P=0.380) at different times did not show a significant difference between the two groups. One week after the operation, the incidence of infection in the bridging technique showed a significant decrease (P=0.045). During the six months of follow-up, the wound healing rate, ischemic pain relief, and claudication improvement were better in the bridging technique but did not show a significant difference with the conventional technique (P<0.05). Patient satisfaction was higher in the bridging technique but did not show a significant difference between the two groups (P<0.05).
Conclusion: It seems that the use of the bridging technique in venous resection large saphenous vein harvesting is associated with reducing wound complications and pain, reducing the length of hospital stay, increasing the speed of wound healing, and improving patient satisfaction. The duration of graft patency and Amputation-free Survival were similar in the two groups. We believe that each technique has advantages and disadvantages that should be considered by the patient and surgeon when choosing a surgical procedure.

Keywords: chronic limb-threatening ischemia, saphenous vein, treatment outcome.


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