Neointima development in externally stented saphenous vein grafts
نویسندگان
چکیده
INTRODUCTION The main limitation of coronary artery bypass grafting (CABG) is rapid neointimal hyperplasia leading to graft failure. AIM To assess plaque formation in saphenous vein grafts (SVG) covered by an external Dacron stent in comparison with the classical technique. MATERIAL AND METHODS In the study group vein grafts covered by external stent mesh made of Dacron were implanted. An intravascular ultrasonography (IVUS) study was performed in 35 aorto-coronary SVG covered by an external Dacron stent and in 64 normal SVG during the first year after CABG. In each SVG 25 mm of good quality IVUS image, volumes of lumen, plaque (neointima), outer border of the vein graft (external SVG) and adventitia were calculated in three time periods: 0-130 days, 130-260 days and 260-390 days. RESULTS Between the first and second time period, lumen volume (mm3) was reduced from 10.33 ±4.4, to 6.80 ±2.23 in the second period and 5.69 ±1.26 in the third one. This effect was much less marked in normal grafts. The corresponding lumen volume (mm3) was: 10.90 ±3.9, 9.15 ±2.94 and 8.92 ±2.93 in consecutive time periods. Plaque volume (mm3) did not change in control grafts during the course of the study, but it increased very significantly in stented grafts from 0.86 ±1.24 in the first period to 2.70 ±1.58 in the second and 3.29 ±2.66 in the third one. CONCLUSIONS The experimental technique of implanting SVG covered with an external elastic Dacron stent seems to be inferior to traditional ones. This is probably due to the more complicated process of vein implantation and higher micro-injury occurrence during the surgery.
منابع مشابه
Neointima development in externally stented saphenous vein grafts. Progress in medicine is good for the patient: why not use total arterial revascularization?
Corresponding author: Przemysław Węglarz MD, 1 Department of Cardiology, Silesian University of Medicine, 45/47 Ziołowa St, 40-635 Katowice, Poland, phone: +48 600 467 332, e-mail: [email protected] Received: 23.01.2017, accepted: 13.02.2017. Neointima development in externally stented saphenous vein grafts. Progress in medicine is good for the patient: why not use total arterial revasculariza...
متن کاملNeointima development in externally stented saphenous vein grafts. External stents are bad for the patient: why not use an undamaged saphenous vein for coronary artery bypass graft?
Corresponding author: Michael R. Dashwood MD, PhD, Department of Surgery, University College London Medical School, Pond St, NW3 2QG London, United Kingdom, phone: +44 (0)20 7794 0500, e-mail: [email protected] Received: 11.01.2017, accepted: 23.01.2017. Neointima development in externally stented saphenous vein grafts. External stents are bad for the patient: why not use an undamaged saphen...
متن کاملFlow Patterns in Externally Stented Saphenous Vein Grafts as Related to the Development of Intimal Hyperplasia
متن کامل
Arterialization of human vein grafts is associated with tenascin-C expression.
OBJECTIVES This study was performed to test the hypothesis that tenascin-C (TN-C), an extracellular matrix (ECM) protein with counteradhesive chemotactic and vascular growth-promoting effects, is expressed in "arterialized" human saphenous vein grafts (SVGs). BACKGROUND Tenascin-C is expressed in the vessel wall after vascular injury in the experimental model, where it has been implicated in ...
متن کاملPeriadventitial rapamycin-eluting microbeads promote vein graft disease in long-term pig vein-into-artery interposition grafts.
BACKGROUND Neointima formation and atherosclerosis compromise long-term graft patency in aortocoronary and peripheral vein bypass grafts. We investigated the short- and long-term effects of periadventitial application of a sustained-release formulation of rapamycin on experimental pig vein grafts with similar dimensions and kinetics to human saphenous vein bypass grafts. METHODS AND RESULTS P...
متن کامل