An Obligatory Role of Perivascular Adipose Tissue in Improved Saphenous Vein Graft Patency in Coronary Artery Bypass Grafting

The gold standard graft for coronary artery bypass grafting (CABG) is the internal thoracic artery (ITA), and the second recommendation is the radial artery. However, complete revascularization with arterial grafts alone is often difficult, and the saphenous vein (SV) is the most commonly used autol...

Full description

Saved in:
Bibliographic Details
Published in:Circulation Journal 2024/05/24, Vol.88(6), pp.845-852
Main Authors: Mikami, Takuma, Dashwood, Michael R., Kawaharada, Nobuyoshi, Furuhashi, Masato
Format: Article
Language:English
Subjects:
Adipose Tissue - transplantation
Coronary Artery Bypass - methods
Coronary artery bypass grafting
Graft Occlusion, Vascular - etiology
Graft Occlusion, Vascular - physiopathology
Humans
No touch technique
Perivascular adipose tissue
Saphenous Vein - transplantation
Saphenous vein harvesting
Stents
Tissue and Organ Harvesting - methods
Vascular Patency
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The gold standard graft for coronary artery bypass grafting (CABG) is the internal thoracic artery (ITA), and the second recommendation is the radial artery. However, complete revascularization with arterial grafts alone is often difficult, and the saphenous vein (SV) is the most commonly used autologous graft for CABG, because it is easier to use without restriction for the length of the graft. On the other hand, the patency of SV grafts (SVGs) is poor compared with that of arterial grafts. The SVG is conventionally harvested as a distended conduit with surrounding tissue removed, a procedure that may cause vascular damage. A no-touch technique of SVG harvesting has been reported to result in improved long-term patency in CABG comparable to that when using the ITA for grafting. Possible reasons for the excellent long-term patency of no-touch SVGs are the physical support provided by preserved surrounding perivascular adipose tissue, preservation of the vascular wall structure including the vasa vasorum, and production of adipocyte-derived factors. In this review, we discuss recent strategies aimed at improving the performance of SVGs, including no-touch harvesting, minimally invasive harvesting and mechanical support using external stents.
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-23-0581