Interposition Vein Cuff for Anastomosis of Prosthesis to Small Artery

Miller, J. H.; Foreman, Robert K.; Ferguson, L.; Faris, Irwin

doi:10.1111/j.1445-2197.1984.tb05318.x

Cited by 233 publications

(85 citation statements)

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“…They optimized the graftartery bypass configurations with computer aided design techniques to ameliorate the hemodynamics [24]. Others studied different configuration variations such as patched, cuffed, side-to-side, and end-to-end anastomosis [13,18,27,[31][32][33][34][35]. Investigations of improved anastomosis configurations are still ongoing.…”

Section: Introductionmentioning

confidence: 99%

Numerical Simulation of Physiological Blood Flow in 2-way Coronary Artery Bypass Grafts

Qiao

Liu

Li³

et al. 2005

J Biol Phys

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Abstract. The Coronary Artery Bypass Graft (CABG) yields excellent results and remains the modern standard of care for treatment of occlusive disease in the cardiovascular system. However, the development of anastomotic Intimal Hyperplasia (IH) and restenosis can compromise the mediumand-long term effects of the CABG. This problem can be correlated with the geometric configuration and hemodynamics of the bypass graft. A novel geometric configuration was proposed for the CABG with two symmetrically implanted grafts for the purpose of improving the hemodynamics. Physiological blood flows in two models of bypass grafts were simulated using numerical methods. One model was for the conventional bypass configuration with a single graft (1-way model); the other model was for the proposed bypass configuration with two grafts (2-way model). The temporal and spatial distributions of hemodynamics, such as flow patterns and Wall Shear Stress (WSS) in the vicinity of the distal anastomoses, were analyzed and compared. Calculation results showed that the 2-way model possessed favorable hemodynamics with uniform longitudinal flow patterns and WSS distributions, which could decrease the probability of restenosis and improve the effect of the surgical treatment. Concerning the limitations of the 2-way bypass grafts, it is necessary to perform animal experiments to verify the viability of this novel idea for the CABG.

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Section: Introductionmentioning

confidence: 99%

Numerical Simulation of Physiological Blood Flow in 2-way Coronary Artery Bypass Grafts

Qiao

Liu

Li³

et al. 2005

J Biol Phys

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“…This suggests that the development of anastomotic intimal hyperplasia could be prevented by lowering the permeability of the endothelium by either topically applying a drug to the vessel wall or externally coating the portion of the vessel with a water-impermeable material. In connection with this, there have been several interesting reports that, in bypass grafting, interposition of a short segment of a vein (a vein cuff) between an expanded polytetrafluoroethylene (ePTFE) graft and an artery at a distal anastomotic site diminished intimal hyperplasia and improved long-term patency rate (MILLER et al, 1984;TYRRELL and WOLFE, 1991;TAYLOR et al, 1992).…”

Section: Application Of the Results Obtained To A Clinical Problemmentioning

confidence: 98%

“…Despite the development of several biocompatible synthetic grafts, such as polytetrafluoroethylene grafts (GuIDOIN et at., 1988), and improvement of operative techniques by incorporating a vein cuff or a patch in end-to-side anastomosis (MILLER et al, 1984;TYRRELL and WOLFE, 1991;TAYLOR et al, 1992), long-term patency of small-diameter grafts is still poor. One of the reasons for that is that the precise mechanisms for the pathogenesis and localisation of intimal hyperplasia have not been elucidated yet.…”

Section: Introductionmentioning

confidence: 98%

Theoretical study of the effect of local flow disturbances on the concentration of low-density lipoproteins at the luminal surface of end-to-end anastomosed vessels

Wada

Koujiya

Karino

2002

Med. Biol. Eng. Comput.

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To elucidate the mechanisms of localisation of intimal hyperplasia in anastomosed arteries, the effects of flow disturbances on the transport of low-density lipoproteins (LDLs) from the flowing blood to the wall of end-to-end anastomosed arteries, with and without a moderate stenosis, were studied theoretically by means of a computer simulation under the condition of steady flow. In an artery with moderate stenosis at the anastomotic junction and intimal thickening distal to it, we found that, owing to the water-permeable nature of the arterial wall, the surface concentration of LDL was elevated up to 20% higher than that of the bulk flow distal to the stenosis, where a recirculation zone was formed and wall shear stresses were low. In contrast to this, no significant elevation of surface concentration of LDLs occurred in another anastomosed vessel in which no stenosis was formed and no intimal thickening was observed. These results suggest that flow-dependent concentration polarisation of LDLs plays a causative role in the localisation of anastomotic intimal hyperplasia in the human arterial system by locally elevating the surface concentration of LDLs, thus augmenting their uptake by endothelial cells.

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“…One of the causes of late occlusion in prosthetic grafts after bypass surgery is anastomotic intimal hyperplasia, and many attempts have been made to prevent such graft failure. [1][2][3] Migration and proliferation of medial smooth muscle cells to the intima are thought to be the major cause of intimal hyperplasia. We hypothesized that the intervention of venous tissue between the arteriosclerotic artery and the graft with DAPP can relieve compliance mismatch, preserve sufficient anastomotic area, and inhibit anastomotic intimal hyperplasia by the effective dispersion of motor energy at the anastomosis through the elastic qualities of the vein and the suppression of turbulence.…”

Section: Introductionmentioning

confidence: 99%

Experimental and Clinical Studies Investigating the Efficacy of Distal Anastomosis with Patch Plasty in Bypass Operations with Expanded Polytetrafluoroethylene Grafts

et al. 2003

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Interposition Vein Cuff for Anastomosis of Prosthesis to Small Artery

Abstract: This paper reports the use of a vein cuff to facilitate the anastomosis of a prosthetic graft to a small artery. This technique makes it easier to perform a good anastomosis and may improve the chances of long‐term patency.

Cited by 233 publications

References 0 publications

Numerical Simulation of Physiological Blood Flow in 2-way Coronary Artery Bypass Grafts

Numerical Simulation of Physiological Blood Flow in 2-way Coronary Artery Bypass Grafts

Theoretical study of the effect of local flow disturbances on the concentration of low-density lipoproteins at the luminal surface of end-to-end anastomosed vessels

Experimental and Clinical Studies Investigating the Efficacy of Distal Anastomosis with Patch Plasty in Bypass Operations with Expanded Polytetrafluoroethylene Grafts

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