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Proximal first: A beneficial anastomotic strategy for no-touch saphenous vein graft.
Multimedia Manual of Cardiothoracic Surgery : MMCTS 2018 June 27
In the mid-1990s, a novel saphenous vein harvesting technique, in which the vein is harvested with its surrounding tissue without manual distention, was introduced. This no-touch technique provides an excellent long-term patency; however, graft twisting and kinking can be a problem. In order to fully take advantage of the benefit of the no-touch method while reducing the risk of twisting and kinking we have modified the anastomosis strategy. Our simple modified strategy involves performing a proximal anastomosis prior to the distal anastomosis.
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