Enhancing vein graft viability

增强静脉移植物的活力

• 批准号: 8003891
• 负责人: Michael James Osgood
• 金额: $ 5.22万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8003891
• 关键词: Blood Vessels; Bypass; Cardiovascular Diseases; Cause of Death; Clinical Trials; Coronary Artery Bypass; Data; Development; Future; Goals; Harvest; Human; Hyperplasia; Injury; Intervention; Isopropanol; Manuals; Modeling; Morbidity - disease rate; Operative Surgical Procedures; Oryctolagus cuniculus; Peripheral; Procedures; Research; Research Personnel; Saline; Saphenous Vein; Skin; Stretching; Techniques; Time; United States; Veins; cost; disability; functional loss; graft failure; improved; in vivo; mortality; pressure; prevent; public health relevance

DESCRIPTION (provided by applicant): Approximately 1,000,000 aortocoronary and peripheral vascular revascularizations are performed each year using human saphenous vein (HSV). The leading cause of graft failure is the subsequent development of intimal hyperplasia. Surgical techniques typically employed for HSV harvest cause injury. These injurious techniques include stretching the vein (longitudinally during harvest and by manual high-pressure intraluminal distension), placing the vein heparinized saline (pH 6.2) after harvest and the use of surgical skin markers applied to the vein (which contain isopropyl alcohol) to properly orient the vein graft. Preliminary data has shown that 40% of HSV harvested for coronary artery bypass procedures have no functional viability. The hypothesis of this proposal is that preventing injury to the vein during harvest will decrease the subsequent development of intimal hyperplasia. This proposal will 1) determine the mechanisms underlying the loss of functional viability of vein grafts; 2) determine if injury to the vein graft leads to the development of intimal hyperplasia in a rabbit carotid interposition vein graft model. While many investigators have suggested that injury is deleterious to the conduit, this notion has not been proven in vivo. Accomplishment of these goals would provide a platform for future clinical trials with simple straightforward interventions that would improve graft patency. This would have a significant impact on the morbidity, mortality, and costs associated with vein graft failure. PUBLIC HEALTH RELEVANCE: Cardiovascular disease is one of the leading causes of death and disability in the United States. Our research could potentially increase the time a bypass graft stays open, and lessen the morbidity and mortality of vein graft failure.

描述（由申请人提供）：每年使用人隐静脉（HSV）进行大约 1,000,000 例主动脉冠状动脉和外周血管血运重建。 The leading cause of graft failure is the subsequent development of intimal hyperplasia. Surgical techniques typically employed for HSV harvest cause injury.这些有害技术包括拉伸静脉（在采集过程中纵向拉伸并通过手动高压腔内扩张），采集后放置静脉肝素盐水（pH 6.2）以及使用应用于静脉的外科皮肤标记（含有异丙醇）以正确定向静脉移植物。 Preliminary data has shown that 40% of HSV harvested for coronary artery bypass procedures have no functional viability.该提议的假设是，在采集过程中防止静脉损伤将减少内膜增生的后续发展。 This proposal will 1) determine the mechanisms underlying the loss of functional viability of vein grafts; 2) determine if injury to the vein graft leads to the development of intimal hyperplasia in a rabbit carotid interposition vein graft model. While many investigators have suggested that injury is deleterious to the conduit, this notion has not been proven in vivo.这些目标的实现将为未来的临床试验提供一个平台，通过简单直接的干预措施来改善移植物的通畅性。 This would have a significant impact on the morbidity, mortality, and costs associated with vein graft failure. PUBLIC HEALTH RELEVANCE: Cardiovascular disease is one of the leading causes of death and disability in the United States. Our research could potentially increase the time a bypass graft stays open, and lessen the morbidity and mortality of vein graft failure.