On the biology of saphenous vein grafts fitted with external synthetic sheaths and stents
On the biology of saphenous vein grafts fitted with external synthetic sheaths and stents
复制标题
DOI：
10.1016/j.biomaterials.2006.10.023
复制
发表时间：
2007-02-01
期刊：
影响因子：
14
通讯作者：
Angelim, Gianni D.
中科院分区：
文献类型：
--
作者：
Jeremy, Jamie Y.;Gadsdon, Pat;Angelim, Gianni D.
自体大隐静脉用作冠状动脉（冠状动脉旁路移植术[CABG]）和股动脉（腹股沟下旁路移植术[IIBS]）中动脉粥样硬化病变的旁路管道。尽管该手术无疑取得了成功和益处，但50%的病例在手术后10年内发生移植失败。晚期静脉移植失败的主要原因是内膜和中膜增生和叠加的动脉粥样硬化形成。除降脂治疗外，迄今为止没有任何干预措施在预防晚期静脉移植物衰竭方面被证明是临床有效的，晚期静脉移植物衰竭显然构成了需要迫切解决的主要临床和经济问题。然而，我们已经研究了外部合成支架和鞘管在静脉到动脉间置移植的猪模型中的作用，发现它们对静脉移植物重塑和增厚具有深远的影响。因此，在这篇综述中，我们将总结静脉移植失败的机制，这些支架如何影响这些过程和可能的机制，以及这些设备在预防静脉移植失败的临床应用。(c)2006爱思唯尔有限公司保留所有权利。
Autologous saphenous vein is used as a conduit to bypass atherosclerotic lesions in both the coronary artery (coronary artery bypass graft surgery [CABG]) and in femoral arteries (infrainguinal bypass graft surgery [IIBS]). Despite the undoubted success and benefits of the procedures, graft failure occurs in 50% of cases within 10 years after surgery. A principal cause of late vein graft failure is intimal and medial hyperplasia and superimposed atherogenesis. Apart from lipid lowering therapy, no intervention has hitherto proved clinically effective in preventing late vein graft failure which clearly constitutes a major clinical and economic problem that needs to be urgently resolved. However, we have studied the effect of external synthetic stents and sheaths in pig models of vein into artery interposition grafting and found them to have a profound effect on vein graft remodelling and thickening. In this review, therefore, we will summarise the mechanisms underlying vein graft failure and how these stents influence these processes and the possible mechanisms involved as well as the application of these devices in preventing vein graft failure clinically. (c) 2006 Elsevier Ltd. All rights reserved.