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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Value of saphenous vein graft markers during subsequent diagnostic cardiac catheterization
L R Peterson1, C R McKenzie, P A Ludbrook
1Division of Cardiovascular Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA. lpeterso@imgate.wustl.edu
Insights
Saphenous vein graft (SVG) markers significantly improve the efficiency of post-coronary artery bypass graft (CABG) cardiac catheterizations. These markers reduce procedure time, radiation exposure, and contrast agent use for patients and clinicians.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Saphenous vein graft (SVG) markers are available but underutilized in coronary artery bypass graft (CABG) surgery.
- Limited data exists on the effectiveness of SVG markers during postsurgery cardiac catheterization.
Purpose of the Study:
- To prospectively evaluate the impact of SVG markers on post-CABG cardiac catheterization procedures.
- To determine if SVG markers enhance procedural efficiency and safety.
Main Methods:
- A prospective study compared post-CABG patients undergoing cardiac catheterization with and without SVG markers.
- Key metrics analyzed included total procedure time, fluoroscopy time, contrast volume, and imaging efficiency.
Main Results:
- Patients with SVG markers showed significantly reduced total procedure time, fluoroscopy time, and contrast agent usage.
- Even after adjustments, SVG markers consistently decreased catheterization and fluoroscopy times.
- Time to image saphenous vein grafts specifically was also reduced with marker use.
Conclusions:
- SVG markers demonstrably improve the efficiency of post-CABG cardiac catheterizations.
- The use of SVG markers reduces patient and clinician exposure to ionizing radiation and contrast agents.
- SVG markers offer significant benefits for the majority of patients undergoing post-CABG catheterization.
Background:
Although saphenous vein graft (SVG) markers have been available for many years, they have not been widely used in coronary artery bypass graft (CABG) surgery. This is likely due to the paucity of data regarding the utility of these markers in postsurgery cardiac catheterization.
Methods:
We performed a prospective study of all post-CABG patients undergoing cardiac catheterization at Barnes-Jewish Hospital over a 6-month period to test our hypothesis that SVG markers would have a beneficial effect on these procedures. Differences in total procedure (arterial) time, time to image only the SVGs, fluoroscopy time, amount of contrast used, number of aortotomies, and number of views required were compared in patients with and without markers.
Results:
Post-CABG patients undergoing catheterization who had markers (n = 76) required significantly less total procedure time (p = 0.007), fluoroscopy time (p = 0.02), and contrast use (p = 0.008). Even after adjusting for the numbers of SVG ostia and numbers of cine views, patients with markers still required less catheterization and fluoroscopy time (p < 0.01, p < 0.02) and time to image only the SVGs (p < 0.05) than those without markers (n = 106).
Conclusions:
SVG markers improve the efficiency of post-CABG catheterizations; they decrease the exposure of patients and cardiologists to ionizing radiation, and they decrease the exposure of patients to potentially toxic contrast agents. SVG markers are beneficial to the vast majority of post-CABG patients.
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