Document Detail

Pre-bypass quality assessment of the long saphenous vein wall with ultrasound and histology.
MedLine Citation:
PMID:  9290558     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Pre-existing unsuspected wall changes in saphenous vein grafts have been implicated in the graft outcome. Pre-bypass assessment of the vein may identify grafts at high risk for failure. This study was conducted to evaluate preoperatively the quality of the long saphenous vein (LSV) wall with ultrasound and histology. DESIGN: Prospective clinical study. MATERIAL AND METHODS: Three particular LSV segments, ankle, knee and mid-thigh, were evaluated preoperatively by ultrasound in 40 limbs of 38 patients, candidates for coronary artery bypass grafting. The venous wall was characterised based on its thickness and echogenicity in three categories: normal, moderately and severely fibrotic. LSV specimens taken from the above sites were also grouped into the same three categories based on their fibrotic content found on histology. RESULTS: In total, 89 vein specimens were evaluated. On ultrasound, 81 specimens were detected as normal (91%), seven as moderately (8%) and one as severely fibrotic (1%). On histology, only eight specimens were found normal (9%), 75 with moderate (84%) and six with severe fibrosis (7%). Similar wall characterisation with both examinations was found in only 19% (17/89) of the specimens. Eighty-one specimens (91%) had some degree of fibrosis on histology. Different grades of fibrosis were found on histology in different sites of the same vein. CONCLUSIONS: Pre-existing wall changes are very common in vein grafts used for bypass surgery. However, the ultrasonic characterisation of the venous wall preoperatively cannot reliably identify these changes.
A D Giannoukas; N Labropoulos; G Stavridis; D Bailey; B Glenville; A N Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  14     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-09-24     Completed Date:  1997-09-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  37-40     Citation Subset:  IM    
Academic Vascular Surgery Unit, St. Mary's Hospital Medical School, London, U.K.
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MeSH Terms
Coronary Artery Bypass*
Middle Aged
Prospective Studies
Saphenous Vein / pathology*,  transplantation,  ultrasonography*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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