Optimal method for harvesting and preserving the reversed autologous vein before extended bypass grafting in patients with critical lower limb ischemia

Krepkogorskiy N.V.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0003-4119-3120

Bredikhin R.A.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0001-5550-1548

Gizatullina N.F.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0001-7677-2937

Sokolova E.O.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0002-5342-3678

Salimkhanov I.A.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0003-0120-0680

Optimal method for harvesting and preserving the reversed autologous vein before extended bypass grafting in patients with critical lower limb ischemia

Authors:

Krepkogorskiy N.V., Bredikhin R.A., Gizatullina N.F., Sokolova E.O., Salimkhanov I.A.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(4): 451‑456

DOI: 10.17116/kardio202417041451

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To cite this article:

Krepkogorskiy NV, Bredikhin RA, Gizatullina NF, Sokolova EO, Salimkhanov IA. Optimal method for harvesting and preserving the reversed autologous vein before extended bypass grafting in patients with critical lower limb ischemia. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(4):451‑456. (In Russ.)
https://doi.org/10.17116/kardio202417041451

Подписка 2025 (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To analyze the optimal method for harvesting and preserving the reversed autologous vein before extended bypass grafting in patients with critical lower limb ischemia.

MATERIAL AND METHODS

We analyzed postoperative outcomes in 325 patients with atherosclerosis of lower limb arteries: group 1 — 125 patients with extended lesion type C and D, Rutherford grade 4—5 («no touch» reversed vein harvesting and preserving in accordance with original technique); group 2 — 200 patients with similar lesions and standard harvesting and preserving of the vein. Patients were followed-up for 2 years. We assessed limb ischemia, graft patency and stenosis, amputations and mortality.

RESULTS

One year after surgery, the risk of stenosis was 1.99 [95% CI: 1.20—3.37] times higher in group 2. Satisfactory state of the leg (Rutherford class 2—3) after a year was more common (by 3.05 [95% CI: 1.65—5.93] times) in the 1^st group. After 2 years, the odds ratio of satisfactory leg status in group 1 compared to group 2 was 3.85 [95% CI: 1.95—8.1] (adjusted for covariates 3.67 [95% CI: 1.82—7.87], p=0.0005).

CONCLUSION

Vein harvesting and preserving in the first group improved graft patency and reduced the incidence of stenosis.

Keywords:

endoscopic vein harvesting

now touch

bridge technique

hydraulic dilation

graft preservation in saline or autologous blood

femoropopliteal bypass

coronary artery bypass grafting

Authors:

Krepkogorskiy N.V.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0003-4119-3120

Bredikhin R.A.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0001-5550-1548

Gizatullina N.F.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0001-7677-2937

Sokolova E.O.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0002-5342-3678

Salimkhanov I.A.

Interregional Clinical Diagnostic Center;
Kazan State Medical University

ORCID: 0000-0003-0120-0680

Received:

25.02.2023

Accepted:

22.08.2023

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