Adaptive changes in autogenous vein grafts for arterial reconstruction: clinical implications.

Adaptive changes in autogenous vein grafts for arterial reconstruction: clinical implications.
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DOI:
10.1016/j.jvs.2009.07.102
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发表时间:
2010-03
影响因子:
4.3
通讯作者:
Owens, Christopher D.
Owens, Christopher D.
中科院分区:
医学2区
文献类型:
--
作者:
Owens, Christopher D.

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对于下肢动脉闭塞性疾病表现最严重的患者,使用自体静脉的旁路手术是最持久的重建方法。然而,旁路移植物狭窄和移植物失败的发生率仍然很高,并且缺乏通畅性的整体改善。一种可能的解释是,狭窄不仅是由于过度增生的内膜增生,而且还由于静脉对动脉环境的适应或重塑不足。虽然在人体内的研究是很难进行的,最近在成像技术的进步,使静脉旁路成熟的更全面的结构检查成为可能。这篇综述总结了最近的翻译努力,以了解人体静脉移植物的结构和功能特性,并将其放置在静脉移植失败的丰富现有文献的背景下。
For patients with the most severe manifestations of lower extremity arterial occlusive disease, bypass surgery using autogenous vein has been the most durable reconstruction. However the incidence of bypass graft stenosis and graft failure remains substantial and wholesale improvements in patency are lacking. One potential explanation is that stenosis arises not only from over exuberant intimal hyperplasia but also due to insufficient adaptation or remodeling of the vein to the arterial environment. Although in vivo human studies are difficult to conduct, recent advances in imaging technology have made possible a more comprehensive structural examination of vein bypass maturation. This review summarizes recent translational efforts to understand the structural and functional properties of human vein grafts and places it within the context of the rich existing literature of vein graft failure.
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