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In medicine, vein graft failure (VGF) is a condition in which vein grafts, which are used as alternative conduits in bypass surgeries (e.g. CABG), get occluded. Veins, mainly the great saphenous vein (GSV) are the most frequently used conduits in bypass surgeries (CABG or PABG), due to their ease of use and availability. [1]
Doctors must decide whether aging grafts should be replaced. Manipulation of vein grafts is avoided because it risks dislodgement of plaque. [27] Minimally invasive direct coronary artery bypass (MIDCAB) strives to avoid a large incision in the sternum. It utilizes off-pump techniques to place a graft, usually of the LIMA at the LAD.
Acute graft occlusion is the occlusion (blockage) of a vascular bypass graft shortly after the bypass is performed. Its causes, which are distinct from those of chronic graft occlusion , include technical failure (e.g. anastomotic stricture, incomplete valve lysis in non-reversed vein) and thrombosis.
Vascular access steal syndrome is a syndrome caused by ischemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic vascular graft–AV fistula) that was installed to provide access for the inflow and outflow of blood during hemodialysis.
Usually, a healthy vein is located and sewn above and below the blockage to bypass the narrowed or blocked femoral artery. [6] This allows the blood to be redirected to flow through the new healthy vessel around the blockage. In some cases, synthetic graft materials (such as polytetrafluoroethylene) are used instead of a vein graft. [1]
Coronary artery bypass graft surgery has been in practice since the 1960s. Historically, vessels—such as the great saphenous vein in the leg or the radial artery in the arm—were obtained using a traditional "open" procedure that required a single, long incision from groin to ankle, or a "bridging" technique that used three or four smaller incisions.
Both the artery and the vein dilate and elongate in response to the greater blood flow and shear stress, but the vein dilates more and becomes "arterialized". In one study, the cephalic vein increased from 2.3 mm to 6.3 mm diameter after 2 months. When the vein is large enough to allow cannulation, the fistula is defined as "mature". [7]
Swelling and inflammation of a vein close to the skin; Congestive heart failure. [3] Long periods of immobility that can be encountered from driving, [4] flying, bed rest/hospitalization, or having an orthopedic cast.