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1.
PLoS One ; 18(2): e0280594, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36724150

RESUMO

Microplastics (MPs) are ubiquitous in the environment, in the human food chain, and have been recently detected in blood and lung tissues. To undertake a pilot analysis of MP contamination in human vein tissue samples with respect to their presence (if any), levels, and characteristics of any particles identified. This study analysed digested human saphenous vein tissue samples (n = 5) using µFTIR spectroscopy (size limitation of 5 µm) to detect and characterise any MPs present. In total, 20 MP particles consisting of five MP polymer types were identified within 4 of the 5 vein tissue samples with an unadjusted average of 29.28 ± 34.88 MP/g of tissue (expressed as 14.99 ± 17.18 MP/g after background subtraction adjustments). Of the MPs detected in vein samples, five polymer types were identified, of irregular shape (90%), with alkyd resin (45%), poly (vinyl propionate/acetate, PVAc (20%) and nylon-ethylene-vinyl acetate, nylon-EVA, tie layer (20%) the most abundant. While the MP levels within tissue samples were not significantly different than those identified within procedural blanks (which represent airborne contamination at time of sampling), they were comprised of different plastic polymer types. The blanks comprised n = 13 MP particles of four MP polymer types with the most abundant being polytetrafluoroethylene (PTFE), then polypropylene (PP), polyethylene terephthalate (PET) and polyfumaronitrile:styrene (FNS), with a mean ± SD of 10.4 ± 9.21, p = 0.293. This study reports the highest level of contamination control and reports unadjusted values alongside different contamination adjustment techniques. This is the first evidence of MP contamination of human vascular tissues. These results support the phenomenon of transport of MPs within human tissues, specifically blood vessels, and this characterisation of types and levels can now inform realistic conditions for laboratory exposure experiments, with the aim of determining vascular health impacts.


Assuntos
Microplásticos , Poluentes Químicos da Água , Humanos , Microplásticos/análise , Plásticos/análise , Projetos Piloto , Nylons , Veia Safena , Poluentes Químicos da Água/análise , Monitoramento Ambiental , Polímeros
2.
J Korean Med Sci ; 38(4): e23, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36718560

RESUMO

BACKGROUND: A proper depth of percutaneous central venous catheter (PCVC) is very important to reduce procedural time and prevent various complications in very low birth weight (VLBW) infants who require minimal handling or have a sensitive skin. The objective of this study was to suggest a formula for faster and proper insertion of PCVC in VLBWIs to prevent unintended consequences of patients' conditions. METHODS: Prospective data of VLBW infants admitted from June 2015 to January 2018 who had PCVC inserted via the great saphenous vein within seven days after birth were analyzed. Correlations of length of inserted PCVC with body weight, body length, and postmenstrual age at the date of PCVC insertion were determined with a linear regression analysis. Using results of this analysis, a formula to determine the optimal insertion length of PCVC was derived. Coefficient of determination was used to assess how well outcomes were replicated by the formula. RESULTS: The formula to predict the proper insertion length of PCVC via the great saphenous vein at popliteal crease level was obtained as follows: Optimal Length (cm) = 3.8 × Body Weight (kg) + 11.1. With everyday movements such as flexion and extension of the lower extremities, the mean difference in catheter tip position was 7.0 ± 3.9 mm, which was not significant enough to escalate the risk of catheter tip displacement. The rate of catheter-related complications was as low as 4.9% in this study. CONCLUSIONS: The formula derived from this study to predict the optimal PCVC insertion length could benefit VLBW infants by reducing procedural time and lowering the risk of complications.


Assuntos
Cateterismo Venoso Central , Cateteres Venosos Centrais , Recém-Nascido , Lactente , Humanos , Estudos Prospectivos , Veia Safena/diagnóstico por imagem , Cateterismo Venoso Central/métodos , Recém-Nascido de muito Baixo Peso , Peso Corporal
3.
World J Surg Oncol ; 21(1): 10, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36647096

RESUMO

BACKGROUND: Donor-recipient diameter discrepancy can be problematic when using an autologous great saphenous vein graft for internal jugular vein reconstruction. A triple-paneled method of saphenous vein grafting is one solution. CASE PRESENTATION: A 54-year-old man with a thyroid papillary carcinoma underwent total thyroidectomy and bilateral neck dissection. An 8-cm segment of the right internal jugular vein was resected. For reconstruction, a 30-cm segment of the great saphenous vein was harvested and divided into three pieces of equal length. After opening each piece longitudinally, they were sutured together in a side-by-side fashion to create a cylinder that was used to reconstruct the internal jugular vein defect. The graft was patent 10 months after the surgery. CONCLUSION: The triple-paneled method is feasible for autologous great saphenous vein graft reconstruction of the internal jugular vein.


Assuntos
Veias Jugulares , Transplantes , Masculino , Humanos , Pessoa de Meia-Idade , Veias Jugulares/cirurgia , Veia Safena/transplante , Esvaziamento Cervical , Tireoidectomia
5.
Phlebology ; 38(1): 62-66, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36524895

RESUMO

OBJECTIVES: It is unclear whether reflux time independently correlates with severity of symptoms in patients with great saphenous vein reflux. METHODS: Eighty patients (mean age 64+/-12.7 years, 56% female) undergoing great saphenous vein (GSV) ablation for symptomatic reflux were assessed prospectively. Fifty-seven underwent ablation with radiofrequency, 23 with cyanoacrylate adhesive. Venous clinical severity score (VCSS) was assessed at, or prior to the time of ablation. The highest reflux time in the GSV was selected. RESULTS: VCSS values ranged from 2 to 20 (median 7). Mean reflux time was 5.3 s (+/-3.3). The Spearman rank correlation yielded a value of rs = -0.123, p (2-tailed) = .279, which was not significant. The patients with concomitant deep vein reflux had higher VCSS (p < .05). Analysis of patients with only superficial vein reflux (n = 45) also demonstrated a poor correlation between VCSS and reflux time (rs = -0.051, p (2-tailed) = .741). CONCLUSION: This prospective study did not demonstrate a correlation between reflux time and VCSS.


Assuntos
Varizes , Insuficiência Venosa , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Veia Safena/cirurgia , Varizes/cirurgia , Varizes/complicações , Insuficiência Venosa/complicações , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
6.
J Vis Exp ; (190)2022 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-36571418

RESUMO

We present the preliminary results of a longitudinal observational study aimed at evaluating the effectiveness and safety at different short- and long-term follow-ups of vascular occlusion of the great saphenous vein (GSV) and small saphenous vein (SSV) affected by severe pathological reflux, using an innovative modified cyanoacrylate surgical glue composed of N-butyl cyanoacrylate and methacryloxy sulfolane (NBCA+MS). Ninety patients, prospectively recruited for 1 year, underwent the study with EcoColor-Doppler (ECD) to evaluate the maximum diameters of the GSV and SSV in the orthostatic position and the reflux time (RT). An RT greater than 0.5 s was considered pathologic. Clinical, etiology, anatomy, and pathophysiology (CEAP) assessment was used for the complete evaluation of each patient in the study. All the patients were treated by NBCA+MS glue to obtain vein occlusion and observed before treatment (baseline; T0), within 6 h after treatment (T1), 1 month after treatment (T2), 3 months after treatment (T3), 6 months after treatment (T4), and 1 year after treatment (T5). Chi-square (χ) analysis was performed to evaluate the effectiveness and safety of the treatment. All the patients participated in the entire duration of the study. Complete occlusion was maintained in 100% of patients at T1, 98.9% at T2 and T3, and 97.8% at T4 and T5 (p < 0.001). None of the patients suffered from post-surgical thrombosis. No blue hyperpigmentation, or paresthesia was observed during the entire observation period. Immediately after treatment, 7.7% of patients needed painkillers; 1 week after treatment, 100% of patients returned to normal life. Vascular occlusion of the great or small saphenous vein using NBCA+MS glue is a safe procedure with persistent benefits after a 1 year follow-up. This procedure can be performed with local anesthesia, allowing a quick return to normal life. Thanks to its low invasiveness, the treatment is not painful.


Assuntos
Embucrilato , Insuficiência Venosa , Humanos , Embucrilato/efeitos adversos , Insuficiência Venosa/induzido quimicamente , Insuficiência Venosa/cirurgia , Veia Safena/diagnóstico por imagem , Veia Safena/cirurgia , Cianoacrilatos/efeitos adversos , Resultado do Tratamento
9.
J Med Case Rep ; 16(1): 410, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36352448

RESUMO

BACKGROUND: Diagnosis of venous aneurysm may be difficult and can be misjudged as mass-like lesions, including hernias. Here we present the case of a patient with a great saphenous vein aneurysm misdiagnosed and operated as an inguinal hernia. CASE PRESENTATION: A 39-year-old Middle Eastern/Persian male presented with left inguinal bulging 15 years ago, which was misdiagnosed and operated on with a diagnosis of inguinal hernia. He was referred to our clinic, in which color Doppler sonography revealed left-sided saphenofemoral junction incompetence with severe flow reversal during the Valsalva maneuver, in favor of a great saphenous vein aneurysm. Ligation of left saphenofemoral junction and stripping of saphenous vein, and stab avulsion phlebotomy of left lower extremity varicose veins, were done. He was discharged the next day after the operation with an uneventful postoperative course or complication on follow-up. CONCLUSION: Venous aneurysms can be misdiagnosed as other, more common, mass-like lesions, such as inguinal hernias. Therefore, our report emphasizes the consideration of thorough assessment and utilization of color duplex sonography to prevent further misdiagnosis and unnecessary intervention and operations.


Assuntos
Aneurisma , Hérnia Inguinal , Varizes , Masculino , Humanos , Adulto , Veia Safena/cirurgia , Varizes/cirurgia , Hérnia Inguinal/diagnóstico por imagem , Hérnia Inguinal/cirurgia , Veia Femoral/cirurgia , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Resultado do Tratamento
10.
J Am Coll Cardiol ; 80(19): 1833-1843, 2022 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-36328694

RESUMO

Approximately 95% of patients of any age undergoing contemporary, coronary bypass surgery will receive at least 1 saphenous vein graft (SVG). It is recognized that SVG will develop progressive and accelerated atherosclerosis, resulting in a stenosis, and in occlusion that occurs in 50% by 10 years postoperatively. For arterial conduits, there is little evidence of progressive failure as for SVG. Could avoidance of SVG (total arterial revascularization [TAR]) lead to a different late (>5 year) survival? A literature review of 23 studies (N = 100,314 matched patients) at a mean 8.8 years postoperative found reduced all-cause mortality for TAR (HR: 0.77; 95% CI: 0.71-0.84; P < 0.001). An expanded analysis with a new unpublished data set (N = 63,288 matched patients) was combined with the literature review (N = 127,565). It found reduced all-cause mortality for TAR (HR: 0.78; 95% CI: 0.72-0.85; P < 0.001). Additional Bayesian analysis found a very high probability of a TAR-associated reduction all-cause mortality.


Assuntos
Ponte de Artéria Coronária , Veia Safena , Humanos , Veia Safena/transplante , Teorema de Bayes , Resultado do Tratamento , Ponte de Artéria Coronária/métodos , Artérias
11.
Free Radic Biol Med ; 193(Pt 2): 694-701, 2022 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-36402438

RESUMO

Nanoparticles have a promising future in biomedical applications and knowing whether they affect ex vivo vascular reactivity is a necessary step before their use in patients. In this study, we have evaluated the vascular effect of cerium dioxide nanoparticles (CeO2NPs) on the human saphenous vein in response to relaxing and contractile agonists. In addition, we have measured the protein expression of key enzymes related to vascular homeostasis and oxidative stress. We found that CeO2NPs increased expression of both SOD isoforms, and the consequent reduction of superoxide anion would enhance the bioavailability of NO explaining the increased vascular sensitivity to sodium nitroprusside in the presence of CeO2NPs. The NOX4 reduction induced by CeO2NPs may lead to lower H2O2 synthesis associated with vasodilation through potassium channels explaining the lower vasodilation to bradykinin. In addition, we showed for the first time, that CeO2NPs increase the expression of ACE2 in human saphenous vein, and it may be the cause of the reduced contraction to angiotensin II. Moreover, we ruled out that CeO2NPs have effect on the protein expression of eNOS, sGC, BKca channels and angiotensin II receptors or modify the vascular response to noradrenaline, endothelin-1 and TXA2 analogue. In conclusion, CeO2NPs show antioxidant properties, and together with their vascular effect, they could be postulated as adjuvants for the treatment of cardiovascular diseases.


Assuntos
Nanopartículas , Veia Safena , Humanos , Antioxidantes/farmacologia , Angiotensina II , Peróxido de Hidrogênio
12.
PLoS One ; 17(10): e0275628, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36301873

RESUMO

INTRODUCTION: Femoro-popliteal bypass with autologous vascular graft is a key revascularization method in chronic limb-threatening ischemia (CLTI). However, the lack of suitable autologous conduit may occur in 15-45% of the patients, necessitating the implantation of prosthetic or allogen grafts. Only little data is available on the outcome of allograft use in CLTI. AIMS: Our objective were to evaluate the long term results of infrainguinal allograft bypass surgery in patients with chronic limb-threatening ischemia (CLTI) and compare the results of arterial and venous allografts. METHODS: Single center, retrospective study analysing the outcomes of infrainguinal allograft bypass surgery in patients with CLTI between January 2007 and December 2017. RESULTS: During a 11-year period, 134 infrainguinal allograft bypasses were performed for CLTI [91 males (67.9%)]. Great saphenous vein (GSV) was implanted in 100 cases, superficial femoral artery (SFA) was implanted in 34 cases. Early postoperative complications appeared in 16.4% of cases and perioperative mortality (<30 days) was 1.4%. Primary patency at one, three and five years was 59%, 44% and 41%, respectively, while secondary patency was 60%, 45% and 41%, respectively. Primary patency of the SFA allografts was significantly higher than GSV allografts (1 year: SFA: 84% vs. GSV: 51% p = 0,001; 3 years: SFA: 76% vs. GSV: 32% p = 0,001; 5 years: SFA: 71% vs. GSV: 30% p = 0.001). Both primary and secondary patency of SFA allograft implanted in below-knee position were significantly higher than GSV bypasses (p = 0.0006; p = 0.0005, respectively). Limb salvage at one, three and five years following surgery was 74%, 64% and 62%, respectively. Long-term survival was 53% at 5 years. CONCLUSION: Allograft implantation is a suitable method for limb salvage in CLTI. The patency of arterial allograft is better than venous allograft patency, especially in below-knee position during infrainguinal allograft bypass surgery.


Assuntos
Isquemia , Doença Arterial Periférica , Masculino , Humanos , Grau de Desobstrução Vascular , Isquemia Crônica Crítica de Membro , Estudos Retrospectivos , Veia Safena/cirurgia , Salvamento de Membro , Aloenxertos , Resultado do Tratamento , Fatores de Risco
13.
Rozhl Chir ; 101(8): 369-374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208931

RESUMO

Varicose veins of lower extremities are a common disorder affecting a significant proportion of adult population. Endovenous techniques have been used in clinical practice for more than 20 years for their radical treatment; of these, laser therapy is one of the most widely utilized options. However, this treatment modality, too, has its specific side effects and complications which can be divided into perioperative (difficult venous access, fiber or sheath damage, vasovagal reaction with a drop in blood pressure and bradycardia, cutaneous thermal injury), and postoperative (bruising and hematomas, exceptionally pain, superficial venous thrombosis (phlebitis) and fibrous cord formation or pigmentations). Paresthesias, infections, arteriovenous fistulas, deep venous thrombosis and pulmonary embolism are very rare. The introduction of new generators with higher wavelengths and fibers with radial emission of laser energy has substantially reduced the side effects and complications. Performing the surgery in the outpatient setting using tumescent local anesthesia and under perioperative ultrasound control is an essential condition of the procedure.


Assuntos
Terapia a Laser , Embolia Pulmonar , Varizes , Trombose Venosa , Adulto , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Extremidade Inferior , Embolia Pulmonar/etiologia , Veia Safena , Resultado do Tratamento , Varizes/cirurgia , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
14.
Rozhl Chir ; 101(8): 395-400, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208935

RESUMO

INTRODUCTION: Endovenous laser ablation (EVLA) is a recognized alternative to surgical treatment of varicose veins, although an optimal laser generator and its settings still remain a matter of debate. The aim of our study was to correlate clinical results with the theoretical advantage of the 1940nm diode laser characterized by high absorption of heat in a thin layer of coagulated tissue. METHODS: From 1/2010 to 12/2021 EVLA was performed in a total of 3529 consecutive patients with varicose veins and ultrasonographically documented superficial venous reflux of lower extremities. Three types of laser were used successively with the wavelengths of 1064 nm, 1470 nm and 1940 nm, respectively. All patients were prospectively enrolled in our registry. An early postoperative followup visit was scheduled including an assessment of venous closure; additional visits were performed only in case of complications. RESULTS: The success of venous closure did not differ (p=0.054) between the three laser types and was over 98%. The catheterbased method made it possible to perform multiple ablations in one procedure the trend was 1.08, 1.31 and 1.62. In 2021 the number of ablations per patient with the laser DL Tethys 1940 nm was 1.79. With this laser it was possible to reduce the total energy applied to one half (8 W, 5080 J/cm). The postoperative course of patients treated using the 1940nm laser was smoother - no other but the early followup visit was needed in 95.6% cases (p.


Assuntos
Terapia a Laser , Varizes , Insuficiência Venosa , Humanos , Terapia a Laser/métodos , Lasers Semicondutores/uso terapêutico , Veia Safena/cirurgia , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/cirurgia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/cirurgia
16.
Ann Ital Chir ; 93: 578-583, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36254762

RESUMO

AIM: To evalue the short-term results obtained in endovenous laser ablation (EVLA) procedure of the varicose insufficiency of the lower limbs with Diode 1470 µm laser compared to Diode 1940 µm laser. MATERIALS OF STUDY: A total of 55 patients were enrolled in the study. The patients were divided into two groups: those subjected to 1470 µm laser treatment in group A and those with 1940 µm laser treatment in group B. The endpoints were: Closure of the target vessel, complications and post-operative pain. RESULTS: There are no intra-and post-operative complications. The occlusion rate of the target veins was 100% at 7- and 60-day controls. The pain perceived in the immediate post-operative and at the controls showed no statistically significant differences between the two groups. However in group B it was necessary to apply lower values of Power (W) and Linear Energy Density (LEED) with a statistically significant difference compared to group A. DISCUSSION: Short-term results demonstrate closure rates comparable to those obtained with 1470 µm lasers. There were no statistically significant differences in the two groups in terms of primary and secondary endpoints. The advantage of using 1940 µm laser technology is that it is possible to dispense a lower linear energy density (LEED) at a lower power (Watt). CONCLUSIONS: Endovenous laser ablation with Diode 1940 µm is particularly suitable and advantageous in the treatment of superficial and small vessels, as well as venous segment adjacent to nerve structures. KEY WORDS: Diode laser, Intravenous ablation, Varicose, Venous insufficiency, Veins.


Assuntos
Terapia a Laser , Varizes , Insuficiência Venosa , Humanos , Terapia a Laser/métodos , Lasers Semicondutores/uso terapêutico , Veia Safena/cirurgia , Resultado do Tratamento , Varizes/cirurgia , Insuficiência Venosa/cirurgia
17.
Khirurgiia (Mosk) ; (10): 44-50, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36223149

RESUMO

OBJECTIVE: To analyze immediate and long-term results of various methods of femoropopliteal bypass grafting with autologous vein using propensity score matching. MATERIAL AND METHODS: A retrospective single-center open study included 464 patients who underwent femoropopliteal bypass grafting with an autologous vein between January 10, 2016 and December 25, 2019 at the Research Institute - Ochapovsky Regional Clinical Hospital No. 1. The following types of autovenous conduits were used: n=266 - reversed autologous vein (group 1); n=59 - in situ autologous vein (group 2); n=73 - upper limb autologous vein (group 3); n=66 - ex situ autologous vein (group 4). The long-term period was 16.6±10.3 months. RESULTS: We used propensity score matching analysis because patients were not comparable for some indicators. Groups 2-4 included small samples of patients, and their number was reduced to less than 10. This did not allow us to draw reliable conclusions about treatment outcomes. In this situation, we decided to allocate two groups: group 1 - ex situ femoropopliteal bypass grafting; group 2 - other variants of femoropopliteal bypass grafting with autologous vein. Propensity score matching allocated 299 people in group 1 and 46 patients in group 2. There were significant differences in early postoperative incidence of autologous vein thrombosis (group 1: n=3 (6.5%), group 2: n=79 (26.4%), p=0.003; OR= 0.19; 95% CI 0.05-0.64) and postoperative wound suppuration (group 1: n=2 (4.3%), group 2: n=52 (17.4%); p=0.02; OR=0.21; 95% CI 0.05-0.91). In long-term postoperative period, significant differences were obtained in the incidence of limb amputation (group 1: n=6 (13%), group 2: n=85 (28.4%); p=0.02; OR=0.37; 95% CI 0.15-0.92) and myocardial infarction (group 1: n=1 (2.2%), group 2: n=43 (14.4%); p=0.02; OR 0.13; 95% CI 0.01-0.98). CONCLUSION: Femoropopliteal bypass grafting ex situ is characterized by lower incidence of graft thrombosis, amputations of the limb, mild decrease in the incidence of infectious complications and all adverse cardiovascular events in early and late postoperative period compared to conventional surgery (reversed autologous vein, in situ autologous vein, upper limb autologous vein).


Assuntos
Isquemia , Trombose , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/cirurgia , Humanos , Isquemia/cirurgia , Artéria Poplítea/diagnóstico por imagem , Artéria Poplítea/cirurgia , Pontuação de Propensão , Estudos Retrospectivos , Veia Safena/transplante , Trombose/etiologia , Resultado do Tratamento , Grau de Desobstrução Vascular
18.
Tex Heart Inst J ; 49(5)2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36223245

RESUMO

Anastomotic complications of the coronary arteries were observed in approximately 5% of patients undergoing Bentall-type surgery. Given the high surgical risk of reoperation, percutaneous coronary intervention could be a treatment for anastomotic complications but is challenging because of the complicated anatomy after Bentall-type surgery. Here, a 70-year-old man underwent a Bentall operation during which the left main coronary artery was accidentally injured. Therefore, coronary artery bypass using a saphenous vein graft was performed. The saphenous vein graft was anastomosed from the right side of the aortic graft to the left main coronary artery. Three years later, the patient presented with an anterior non-ST-segment elevation myocardial infarction. Because his unusual anatomy, the saphenous vein graft could not be cannulated with diagnostic catheters, even after perusing the surgical record of the Bentall surgery. Subsequently, coronary computed tomography angiography was performed. Three-dimensional reconstructed images visualized the positional relationship between the saphenous vein graft and anatomical landmarks, such as the implanted surgical valve prosthesis. The angiogram angle was adjusted using these landmarks and projection angles estimated by the images. Then, the ASAHI Hyperion Judkins right 4 catheter could be easily inserted, and percutaneous coronary intervention was successfully performed. Three-dimensional reconstruction images were useful for performing percutaneous coronary intervention by aiding in the identification of the anatomic location of the saphenous vein graft and the positional relationship between the saphenous vein graft and anatomic landmarks. In patients with unusual anatomy, as in this case, coronary computed tomography angiography should be strongly considered.


Assuntos
Infarto do Miocárdio sem Supradesnível do Segmento ST , Intervenção Coronária Percutânea , Idoso , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Humanos , Imageamento Tridimensional , Masculino , Intervenção Coronária Percutânea/efeitos adversos , Veia Safena/diagnóstico por imagem , Veia Safena/transplante
20.
Interv Cardiol Clin ; 11(4): 383-391, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36243484

RESUMO

Even though saphenous vein grafts (SVGs) are the most commonly used surgical conduits, their long-term patency is limited by accelerated atherosclerosis often resulting in acute coronary syndrome or asymptomatic occlusion. SVG intervention is associated with 2 significant challenges: a significant risk of distal embolization with resultant periprocedural myocardial infarction in the short-term and restenosis in the long-term. Several individual trials have compared bare metal stents with drug-eluting stents for SVG intervention. This review article discusses the pathophysiology of SVG lesions, indications for SVG intervention, and the challenges encountered, and also technical considerations for SVG intervention and the supporting evidence.


Assuntos
Angioplastia Coronária com Balão , Stents Farmacológicos , Ponte de Artéria Coronária , Oclusão de Enxerto Vascular/cirurgia , Humanos , Veia Safena/transplante
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