On the biology of saphenous vein grafts fitted with external synthetic sheaths and stents

Jeremy, Jamie Y.; Gadsdon, P; Shukla, Nilima; Vijayan, Vikram; Wyatt, Marcella; Newby, Andrew C.; Angelini, Gianni

doi:10.1016/j.biomaterials.2006.10.023

Cited by 81 publications

(94 citation statements)

References 76 publications

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“…Mechanical external stents for SVGs have shown considerable promise in pre-clinical testing with reduction of proliferative intimal hyperplasia by reducing wall tension, improving lumen uniformity and creating a protective "neo-adventitia" layer rich with micro vasculature (11)(12)(13). However, limited clinical data has been published to date with such devices.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial of External Stenting for Saphenous Vein Grafts in Coronary Artery Bypass Grafting

Taggart

Gal

Lees

et al. 2015

The Annals of Thoracic Surgery

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Section: Introductionmentioning

confidence: 99%

A Randomized Trial of External Stenting for Saphenous Vein Grafts in Coronary Artery Bypass Grafting

Taggart

Gal

Lees

et al. 2015

The Annals of Thoracic Surgery

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“…Mechanical external stents for SVGs have shown significant reductions of proliferative intimal hyperplasia, foam cells deposition, and other vascular disease markers in pre-clinical testing (10)(11)(12)(13). This protective effect of external stents is attributed to the reduction in SVG wall tension, the improvement of lumen uniformity and the formation of a "neo-adventitia" layer rich with micro vasculature (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…This protective effect of external stents is attributed to the reduction in SVG wall tension, the improvement of lumen uniformity and the formation of a "neo-adventitia" layer rich with micro vasculature (10)(11)(12)(13)(14). The VEST (Vascular Graft Solutions Ltd, Tel Aviv, Israel) is a kink resistant cobalt-chromium braided mesh, applied externally to the vein graft during surgery.…”

Section: Introductionmentioning

confidence: 99%

Flow patterns in externally stented saphenous vein grafts and development of intimal hyperplasia

Meirson

Orion²,

Mario

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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“…After harvesting, the perivenous vasa vasorum fails to function effectively and cells migrate towards the inner layers, where oxygen is diffusing from the arterial circulation. Pre-clinical research has shown that external support affects venous wall remodeling by facilitating adventitial neovascularization which is critical to prevent migration of cells from the media and adventitia towards the inner layers [22]. In addition, external support may have a role in redirecting vascular smooth muscle cell migration through a reversed chemotactic gradient.…”

Section: Resultsmentioning

confidence: 99%

Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support

Nitecki¹,

Yosef²,

Tozzi³

et al. 2018

Arch Clin Exp Surg

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IntroductionThe autologous vein bypass remains the most effective and durable revascularization strategy for patients with critical limb ischemia [1]. However, despite significant advances in the understanding of venous pathophysiology post-implantation, little progress was made in the clinical setting in which vein graft failure rate is still 30 -50% within 3 to 5 years [1,2].Early graft occlusion, within one month from implantation, is generally ascribed to technical or procedural related complications (e.g., kinking and twisting) or poor conduit quality. Late vein graft failure is attributed to the structural changes that occur in the conduit immediately post-implantation due to the exposure to Following completion of the first anastomosis, randomization was performed to allocate the experimental and control grafts in each animal. Post-procedure, Doppler US was used to assess grafts lumen diameter at T0 and then 3-5 and 12-14 weeks after surgery. At 12-14 weeks, all sheep underwent angiography to assess grafts patency and lumen uniformity (coefficient of variance -CV) after which they were sacrificed, and all grafts were harvested for microscopic histological analysis. Results: Baseline (T0) internal diameter was not significantly different between the supported and unsupported grafts. At twelve to fourteen weeks, the internal diameter of supported grafts remained unchanged and was significantly lower compared to the non-supported grafts (6.6mm±0.4mm vs. 12.8mm±4.0mm respectively, p= 0.0001). Percentage coefficient of variance (%CV) was 4.6% ± 4.3 in the supported grafts as opposed to average CV% of 14.7% ±6.5 in the non-stented group (p=0.011). Neointimal area was significantly lower in the stented compared to the non-stented group (1.4 mm2± 3.3mm2 versus 9.6mm2 ± 9.7mm2 respectively, p=0.009). Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support Conclusions:External support of vein grafts using a braided cobalt chrome external stent reduces early vein graft remodeling and mitigates the development of neointimal hyperplasia.

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On the biology of saphenous vein grafts fitted with external synthetic sheaths and stents

Cited by 81 publications

References 76 publications

A Randomized Trial of External Stenting for Saphenous Vein Grafts in Coronary Artery Bypass Grafting

A Randomized Trial of External Stenting for Saphenous Vein Grafts in Coronary Artery Bypass Grafting

Flow patterns in externally stented saphenous vein grafts and development of intimal hyperplasia

Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support

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