Endarterectomy and Surgical Angioplasty Without Cardiopulmonary Bypass

Abstract

Surgical angioplasty for ostial stenosis of the major coronary arteries is a well-established treatment modality. Management of discrete stenoses of distal coronary arteries in the presence of mild proximal disease is a challenging task. Percutaneous intervention or grafting beyond the diseased segment may be limited by size of the target vessel, whereas endarterectomy followed by graft placement may result in graft occlusion due to competitive native flow. Patch angioplasty with or without endarterectomy is an effective option in this setting, which can be performed without cardiopulmonary bypass in the appropriate group of patients. A patient with triple vessel coronary artery disease and a discrete lesion in the posterior descending artery underwent off-pump endarterectomy with vein patch angioplasty in combination with bypass grafting to left anterior descending and obtuse marginal arteries. Operative technique and intraoperative strategies are discussed.

Farrerol Inhibits Vascular Smooth Muscle Cell Proliferation and Protects Them From Oxidative Injury via Bidirectional Modulation of the PI3K/Akt/mTOR Signaling Pathway

“…Vascular interventions, such as angioplasty, endarterectomy, or surgical bypass grafting, are performed to treat various vascular diseases, including atherosclerosis, a major global cause of human morbidity and mortality. [1][2][3] However, severe intimal hyperplasia (IH) and consequent vascular restenosis are major drawbacks of such vascular interventions. 4,5 Thus, therapeutic strategies against IH could be beneficial for the treatment of vascular diseases, and it is important to discover agents to efficiently treat IH and prevent the further progression of restenosis.…”