Saphenous vein graft
| Saphenous vein graft |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Overview
Normal Anatomy
The great saphenous vein (GSV) originates from where the dorsal vein of the first digit (the large toe) merges with the dorsal venous arch of the foot.
After passing anterior to the medial malleolus (where it often can be visualized and palpated), it runs up the medial side of the leg. At the knee, it runs over the posterior border of the medial epicondyle of the femur bone.
The great saphenous vein then courses laterally to lie on the anterior surface of the thigh before entering an opening in the fascia lata called the saphenous opening. It joins with the femoral vein in the region of the femoral triangle at the saphenofemoral junction.
The small saphenous vein (also lesser saphenous vein) is originated where the dorsal vein from the fifth digit (smallest toe) merges with the dorsal venous arch of the foot, which attaches to the great saphenous vein. It is considered a superficial vein and is subcutaneous (just under the skin). From its origin, it courses around the lateral aspect of the foot (inferior and posterior to the lateral malleolus) and runs along the posterior aspect of the leg (with the sural nerve), passes between the heads of the gastrocnemius muscle, and drains into the popliteal vein, approximately at or above the level of the knee joint.
Preparation (Saphenous vein harvesting)
Mini Invasive Technique
Side Effects of Saphenous Vein Stripping
- Saphenous nerve injury
Diagnostic & Evaluation Findings
Coronary Angiography
CT Angiography
MR Angiography
Pathological Findings
Saphenous Vein Graft Diseases
Venospastic Phenomena of Saphenous Vein Bypass Grafts
Saphenous Vein Graft Aneurysms
It is also known as SVGA, aortocoronary saphenous vein graft aneurysms, saphenous vein graft aneurysm disease and saphenous vein graft aneurysmal dilatation.
Causes of Saphenous Vein Graft Aneurysms
- Atherosclerosis
- Hypertension
- Mycotic
- Postoperative mediastinitis
- Previous aneurysms
- Torn sutures
Saphenous Vein Graft Degeneration
Saphenous Vein Graft Occlusion
Amyloidosis of Saphenous Coronary Bypass Grafts [1] [2] [3] [4] [5]
Treatment
Thrombolysis
PCI
Plain Old Balloon Angioplasty (POBA)
Bare Metal Stents
Drug Eluting Stents
Excimer Laser Coronary Angioplasty (ELCA) of Saphenous Vein Grafts
At the end of 80's [6], ELCA was introduced and thought to be particularly suitable for saphenous vein grafts that were otherwise difficult to treat with balloon angioplasty alone.[7]
Surgery (Re-do)
Videos
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References
- ↑ Marti MC, Bouchardy B, Cox JN. Aortocoronary bypass with autogenous saphenous vein grafts: histopathological aspects. Virchows Arch Abt A Path Anat 1971; 352: 255–66.
- ↑ Garrett HE, Dennis EW, DeBakey ME. Aortocoronary bypass with saphenous vein graft. JAMA 1973; 223: 792–4.
- ↑ Zemva A, Ferluga D, Zorc M, Popovic M, Porenta OV, Radovanovic N. Amyloidosis in saphenous vein aortocoronary bypass grafts. J Cardiovasc Surg 1990; 31: 441–4.
- ↑ Salerno TA, Wasan SM, Charrette EJ. Prospective analysis of heart biopsies in coronary artery surgery. Ann Thorac Surg 1979; 28: 436–9.
- ↑ Pelosi F, Capehart J, Roberts WC. Effectiveness of cardiac transplantation for primary (AL) cardiac amyloidosis. Am J Cardiol 1997; 79: 532–5.
- ↑ Litvack F, Grundfest WS, Goldenberg T, et al. Percutaneous excimer laser angioplasty of aortocoronary saphenous vein grafts. J Am CoIlCardiol 1989; 14:803-8.
- ↑ Bittl JA, Sanborn TA, Tcheng JE, et al. Clinical success, complications and restenosis rates with excimer laser coronary angioplasty. Am J Cardiol 1992; 70: 1533-9.