In recent times, practice in cardiac surgery has shifted towards using endoscopic techniques to harvest the saphenous vein from the leg for use as a bypass graft. A paper published in the New England Journal of Medicine (NEJM) in 2009 raised concerns over increased graft occlusion rates in veins harvested endoscopically. This NEJM paper has been criticized, but has nonetheless been influential ...

I have alwayswanted to be adoctor.Manyaspects ofmedicine enthralled me: research, diagnosis, and the possibility of improving a patient’s quality of life, in particular.Walking the corridors of a hospital felt exhilarating. At 15 I had a volunteer position at the local hospital. Although my assignments were answering phones, directing visitors, and, my favorite, delivering goods topatients, I f...

OBJECTIVE To find out whether intraoperative angioscopic assistance has any effect on graft outcome in patients with critical leg ischemia. MATERIAL AND METHODS One hundred one patients requiring a below-knee bypass were assigned to undergo in situ saphenous vein bypass with or without intraoperative angioscopic assistance; otherwise treated similarly including preoperative duplex vein mappin...

Despite the very important use of arterial bypass conduits, vein grafts remain one cornerstone in coronary surgery. Newer studies show a saphenous vein graft patency of about 60% at 10 years postoperatively. This article reviews the in vivo (animal) models of vein graft disease. According to the different models, the findings on pathology of graft thrombosis, neointimal hyperplasia, and vein gr...

PURPOSE The purpose of this study was to compare four graft-tunnel angles (GTA), the femoral GTA formed by three different femoral tunneling techniques (the outside-in, a modified inside-out technique in the posterior sag position with knee hyperflexion, and the conventional inside-out technique) and the tibia GTA in 3-dimensional (3D) knee flexion models, as well as to examine the influence of...

OBJECTIVE Previous studies have suggested that neointimal formation, a central cause of vein graft stenosis, has several potential cell sources. It was hypothesized that neointimal cells arise primarily from the cells of the vein graft. METHODS AND RESULTS This study investigated vein graft neointimal cell origins using a model of vein-to-artery cross-transplantation between transgenic Rosa26...

BACKGROUND Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis. METHODS An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were invest...

Figure 1 (A and B) Vein graft aneurysm with mural thrombus (labelled *) on echocardiography, in modified parasternal longand short-axis views (LV, left ventricle); (C) vein graft aneurysm demonstrating flow within the aneurysm, on colour Doppler echocardiography, in modified long-axis view; (D) angiogram of vein graft aneu vein graft compressing onto the pulmo different orthogonal views on compute

BACKGROUND Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surg...

OBJECTIVE Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper ...