Prospective study of the value of prebypass saphenous vein angioscopy

Clifford M. Sales, Jamie Goldsmith, Frank J. Veith

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The patency of a saphenous vein graft is directly related to the quality of the vein harvested. Thus, appropriate evaluation of the vein before implanting it as a bypass graft may help identify those veins at high risk for early failure. Accordingly, we prospectively investigated whether prebypass angioscopic assessment of the saphenous vein could identify those vein grafts at particularly high risk of early failure. Patients and methods: Thirty-two greater saphenous veins with a grossly normal appearance were evaluated angioscopically before their use as a bypass conduit. After modification of abnormal segments, all of the veins irrigated well and were used as bypass grafts. Results: Twenty-four patients were available for follow-up at 12 months. Seventeen (71%) had been prospectively classified as having angioscopically normal saphenous veins, while 7 were identified as having abnormal veins. The two groups did not differ significantly in demographics, cardiovascular risk factors, or indications for operative intervention. Twelve of the 17 (70%) normal veins were patent at 1 year; however, only 1 (14%) of the angioscopically abnormal vein grafts remained patent for 12 months (chi-square = 4.27; P = 0.039). Conclusion: Angioscopic inspection of the saphenous vein, before insertion as a graft, allows for identification of unrecognized venous disease that portends early graft thrombosis. Exclusion of abnormal veins, based on an abnormal angioscopic appearance, may lead to improved results for lower-extremity revascularization procedures; this supports the value of vein-graft angioscopy.

Original languageEnglish (US)
Pages (from-to)106-108
Number of pages3
JournalThe American Journal of Surgery
Volume170
Issue number2
DOIs
StatePublished - Aug 1995
Externally publishedYes

Fingerprint

Angioscopy
Saphenous Vein
Veins
Prospective Studies
Transplants
Lower Extremity
Thrombosis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Sales, Clifford M. ; Goldsmith, Jamie ; Veith, Frank J. / Prospective study of the value of prebypass saphenous vein angioscopy. In: The American Journal of Surgery. 1995 ; Vol. 170, No. 2. pp. 106-108.
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abstract = "Background: The patency of a saphenous vein graft is directly related to the quality of the vein harvested. Thus, appropriate evaluation of the vein before implanting it as a bypass graft may help identify those veins at high risk for early failure. Accordingly, we prospectively investigated whether prebypass angioscopic assessment of the saphenous vein could identify those vein grafts at particularly high risk of early failure. Patients and methods: Thirty-two greater saphenous veins with a grossly normal appearance were evaluated angioscopically before their use as a bypass conduit. After modification of abnormal segments, all of the veins irrigated well and were used as bypass grafts. Results: Twenty-four patients were available for follow-up at 12 months. Seventeen (71{\%}) had been prospectively classified as having angioscopically normal saphenous veins, while 7 were identified as having abnormal veins. The two groups did not differ significantly in demographics, cardiovascular risk factors, or indications for operative intervention. Twelve of the 17 (70{\%}) normal veins were patent at 1 year; however, only 1 (14{\%}) of the angioscopically abnormal vein grafts remained patent for 12 months (chi-square = 4.27; P = 0.039). Conclusion: Angioscopic inspection of the saphenous vein, before insertion as a graft, allows for identification of unrecognized venous disease that portends early graft thrombosis. Exclusion of abnormal veins, based on an abnormal angioscopic appearance, may lead to improved results for lower-extremity revascularization procedures; this supports the value of vein-graft angioscopy.",
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Prospective study of the value of prebypass saphenous vein angioscopy. / Sales, Clifford M.; Goldsmith, Jamie; Veith, Frank J.

In: The American Journal of Surgery, Vol. 170, No. 2, 08.1995, p. 106-108.

Research output: Contribution to journalArticle

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