Autogenous Vein Grafts

Berceli, Scott A.

doi:10.1016/b978-1-4160-5223-4.00087-1

Cited by 6 publications

(5 citation statements)

References 184 publications

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“…Th is process is important because these factors keep the normal vessel wall in a state of low cell turnover with low rates of proliferation and apoptosis. Injury or changes to the environment, as when veins are exposed to arterial fl ow, can increase the rates of proliferation or apoptosis [1,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Characterisation of blood vessels used for coronary artery bypass surgery

Garnizone

Vārtiņa

Pilmane

2019

PoA

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Saphenous veins are commonly used as coronary artery bypass grafts. Therefore, it is important to understand the vein wall morphology used for the bypass grafts. Methods. Ten specimens of saphenous veins were obtained from 10 patients admitted to the Heart Surgery Centre of P. Stradiņš Clinical University Hospital for coronary artery bypass surgery and a histopathological study was conducted. The slides were processed for histological routine and immunohistochemical staining with following markers: endothelin (ET), metallomembranoproteinase 2 (MMP2), tissue inhibitor of metalloproteinase 2 (TIMP2), transforming growth factor beta (TGF β), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), protein gene product 9.5 (PGP9.5), vascular cell adhesion molecule (VCAM), intercellular adhesion molecule (ICAM). For the analysis of the positive structures detected by immunohistochemistry, a semiquantitative evaluation method was used. Results. Normal histoarchitecture of the vein wall was evaluated by routine staining. Moderate positive endothelin containing endothelial cells and moderate to numerous positive VEGF cells were found on small blood vessels. Moderate positive MMP2 structures and variable – mainly moderate to numerous positive TIMP structures – were found in vein wall. Positive structures were evaluated as equal with both MMP2 and TIMP, with one exception where MMP2 positive structures were evaluated as moderate, but TIMP positive structures as few. All specimens were rich in TGFβ, VCAM and ICAM cells. Abundance of VCAM and ICAM positive endothelial cells was also found. Few HGF positive structures were found in tunica intima and few PGP9.5 positive nerve fibres in tunica adventitia. Conclusions. Rich expression of TGFβ, VCAM, ICAM is characteristic for saphenous vein. A number of VEGF, MMP and TIMP positive cells found in saphenous vein wall indicates a presence of tissue remodelling and ischemia, while low number of HGF positive cells shows its lesser involvement in homeostasis regulation.

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Section: Introductionmentioning

confidence: 99%

“…Compared with vasa vasorum of the corresponding arteries, vasa vasorum are much more extensive in venous adventitia and penetrate into deeper regions of the adventitia as well. Lower oxygen tension in venous blood is a possible explanation for this phenomenon [1,3,10].…”

Section: Introductionmentioning

confidence: 99%

Characterisation of blood vessels used for coronary artery bypass surgery

Garnizone

Vārtiņa

Pilmane

2019

PoA

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“…Although this technique may take additional time and familiarity with the approach, it has been shown to decrease wound complications (9.6%) in at least one large series. 11 The least invasive technique for saphenous vein harvesting is the endoscopic approach. With this technique the vein is harvested with electrocautery through several percutaneous incisions.…”

Section: Introductionmentioning

confidence: 99%

Damage Control

Singh¹,

Quan²

2016

Rich's Vascular Trauma

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“…3 The rate of vein graft failure among patients undergoing infrainguinal bypass ranges from 30% to 45% at 4 to 12 months postoperatively. 4 The rate of per-patient vein graft failure 12 to 18 months after CABG was 45% among 1,920 patients in the Prevention of Vein Graft Failure Following Coronary Artery Bypass Graft Surgery (PREVENT) IV trial. 5 …”

Section: Introductionmentioning

confidence: 99%

Role of the Renin–Angiotensin System in the Pathogenesis of Intimal Hyperplasia: Therapeutic Potential for Prevention of Vein Graft Failure?

Osgood

Harrison

Sexton

et al. 2012

Annals of Vascular Surgery

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The saphenous vein remains the most widely used conduit for peripheral and coronary revascularization despite a high rate of vein graft failure. The most common cause of vein graft failure is intimal hyperplasia. No agents have been proven to be successful for the prevention of intimal hyperplasia in human subjects. The rennin–angiotensin system is essential in the regulation of vascular tone and blood pressure in physiologic conditions. However, this system mediates cardiovascular remodeling in pathophysiologic states. Angiotensin II is becoming increasingly recognized as a potential mediator of intimal hyperplasia. Drugs modulating the renin–angiotensin system include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. These drugs are powerful inhibitors of atherosclerosis and cardiovascular remodeling, and they are first-line agents for management of several medical conditions based on class I evidence that they delay progression of cardiovascular disease and improve survival. Several experimental models have demonstrated that these agents are capable of inhibiting intimal hyperplasia. However, there are no data supporting their role in prevention of intimal hyperplasia in patients with vein grafts. This review summarizes the physiology of the rennin–angiotensin system, the role of angiotensin II in the pathogenesis of cardiovascular remodeling, the medical indications for these agents, and the experimental data supporting an important role of the rennin–angiotensin system in the pathogenesis of intimal hyperplasia.

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Autogenous Vein Grafts

Cited by 6 publications

References 184 publications

Characterisation of blood vessels used for coronary artery bypass surgery

Characterisation of blood vessels used for coronary artery bypass surgery

Damage Control

Role of the Renin–Angiotensin System in the Pathogenesis of Intimal Hyperplasia: Therapeutic Potential for Prevention of Vein Graft Failure?

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