Incidence of Stenoses in Femorodistal Bypass Vein Grafts in a Multicentre Study

Abstract

Female patients, those taking aspirin and patients with composite vein grafts appear to be more at risk of graft stenosis, but this does not fully explain wide variations in the incidence of stenoses reported by individual centres.

Therapeutic approach against intimal hyperplasia of vein grafts through endothelial nitric oxide synthase/nitric oxide (eNOS/NO) and the Rho/Rho-kinase pathway

“…13,16,17 Clinical trials have shown that the expected patencies of implanted vein grafts are lower in patients with poor runoff vessels in particular. [2][3][4]8 One study using a poor distal runoff canine model has demonstrated that hemodynamic factors such as a low fl ow velocity and a low shear stress are strong accelerators of intimal thickening. 18,19 This accelerated intimal thickening is reversed when the grafts are reimplanted into a system with a normal fl ow.…”

“…[1][2][3] However, the long-term vein graft patency is limited by both progressive intimal hyperplasia and subsequent atherosclerosis. 4 In the fi rst postoperative month, the principal cause of early failure in vein grafts is related to problems in the surgical techniques. That is to say, trauma to the vein during surgical preparation can denude the endothelium, damage the vessel wall, and predispose the graft to early thrombosis.…”

Pitavastatin Inhibits Intimal Hyperplasia in Rabbit Vein Graft

“…However, the patency is not always complete; graft failure may occur [1][2][3]. Intimal hyperplasia of the vein graft is one of the main causes of graft failure.…”

Flow pattern and shear stress distribution of distal end-to-side anastomoses. A comparison of the instantaneous velocity fields obtained by particle image velocimetry

“…One of the most important reasons for the inferior longterm results is the development of intimal hyperplasia at the distal anastomoses (Mills et al, 1993;Lemson et al, 2000;Watson et al, 2000). During the last several years a variety of distal anastomoses forms have been introduced, but the ''gold standard'' has not been established (Taylor et al, 1992;Miller et al, 1984;Ruckert et al, 2000).…”