Reappraisal of a 20-year experience with the radial artery as a conduit for coronary bypass grafting

Achouh, Paul; Isselmou, Khaled Ould; Boutekadjirt, Redha; D’Alessandro, Cosimo; Pagny, Jean-Yves; Fouquet, Regis; Fabiani, Jean‐Noël; Acar, Christophe

doi:10.1016/j.ejcts.2011.05.027

Cited by 55 publications

(55 citation statements)

References 24 publications

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“…26 In fact, the 7-year patency rates for the vein grafts were similar to the radial artery conduits in a randomized Australian trial, 26 as well as in a retrospective French series with 20-year follow-up. 27 Despite a very large number of clinical trials, apart from the lipid-lowering drugs, no other pharmacological agents appear to have beneficial effects on early vein graft remodeling or subsequent accelerated atherosclerosis. For this reason, alternative and novel therapeutic strategies are urgently required.…”

Section: Discussionmentioning

confidence: 99%

Sustained Reduction of Vein Graft Neointima Formation by Ex Vivo TIMP-3 Gene Therapy

George

Wan

et al. 2011

Circulation

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Background— Coronary artery vein graft failure, resulting from thrombosis, intimal thickening, and atherosclerosis, is a significant clinical problem, with approximately 50% of vein grafts failing within 10 years. Intimal thickening is caused by migration of vascular smooth muscle cells from the media to the intima, where they proliferate. Interventions using gene transfer to inhibit vascular smooth muscle cells proliferation and migration are attractive because ex vivo access to the graft is possible. The involvement of matrix-degrading metalloproteinases in intimal thickening is well established, and we previously showed that adenoviral-delivered overexpression of an endogenous inhibitor, the tissue inhibitor of metalloproteinases-3 (TIMP-3), significantly retarded intimal thickening in short-term autologous porcine arteriovenous interposition grafts (28 days). However, it is essential to determine whether this approach will provide longer-term benefits. Methods and Results— We assessed whether a recombinant adenovirus that overexpresses TIMP-3 (RAdTIMP-3) affects vein graft intimal thickening in the longer term (at 3 months). Porcine saphenous veins were subjected to luminal infection with 2.5×10 10 pfu/mL RAdTIMP-3 or RAd60 (control virus) or vehicle control, for 30 minutes before implantation into the carotid artery. Analysis of grafts harvested 3 months after delivery revealed that RAdTIMP-3–infected grafts had significantly reduced intimal areas compared with both controls (3.2±0.4 mm 2 versus 5.6±0.7 mm 2 and 5.9±0.5 mm 2 , RAdTIMP-3, RAd60, and vehicle, respectively). Medial areas were also significantly decreased by TIMP-3 (3.8±0.3 mm 2 versus 6.7±1.0 mm 2 and 5.2±0.4 mm 2 , RAdTIMP-3, RAd60, and vehicle, respectively). Conclusions— Overexpression of TIMP-3 provides a sustained retardation of vein graft intimal thickening and highlights the translational potential for ex vivo TIMP-3 gene therapy.

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Section: Discussionmentioning

confidence: 99%

Sustained Reduction of Vein Graft Neointima Formation by Ex Vivo TIMP-3 Gene Therapy

George

Wan

et al. 2011

Circulation

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“…The 2014 ESC/EACTS Guidelines were written following the publication of several additional important randomized and observational studies concerning RA grafting [24][25][26]. One table in these guidelines summarizes the early, mid and late patency of the RA in addition to SV grafts and left and right IMAs-RA patency exceeds that of SVs but is likely less than the left or right IMA [1].…”

Section: Radial Arterymentioning

confidence: 99%

Transatlantic editorial: A comparison between European and North American guidelines on myocardial revascularization

Kolh

Kurlansky

Cremer

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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“…In fact, the 7-year patency rates for the vein grafts were also similar to the radial artery conduits in a randomised Australian trial 11 as well as in a retrospective French series with 20-year follow-up. 14 The relevance of vein graft failure, therefore, should not be overlooked.…”

Section: Clinical Use Of Autologous Saphenous Veinmentioning

confidence: 99%

Vein graft failure: current clinical practice and potential for gene therapeutics

et al. 2012

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Autologous saphenous vein is commonly used as a conduit to bypass atherosclerotic lesions in coronary and femoral arteries. Despite the wide use of arterial conduits, which are less susceptible to complications and failure, as alternative conduits, the saphenous vein will continue to be used in coronary artery bypass grafting until acceptable alternative approaches are evaluated. Hence, preservation of vein graft patency is essential for the long-term success. Gene therapy is attractive in this setting as an ex-vivo technology to genetically manipulate the conduit before grafting. The use of safe and efficient vectors for delivery is a necessity as well as a strategy to improve patency in the long term. Here, we review the current clinical practice, the pathogenesis of bypass graft failure and adenovirus-mediated gene therapy strategies designed to improve late vein graft failure by modulation of smooth muscle cells in the vein wall.

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Reappraisal of a 20-year experience with the radial artery as a conduit for coronary bypass grafting

Abstract: CABG with the RA offered long-lasting clinical benefit. Beyond the first postoperative year during which some attrition was observed, RA patency was remarkably stable for up to 20 years.

Cited by 55 publications

References 24 publications

Sustained Reduction of Vein Graft Neointima Formation by Ex Vivo TIMP-3 Gene Therapy

Sustained Reduction of Vein Graft Neointima Formation by Ex Vivo TIMP-3 Gene Therapy

Transatlantic editorial: A comparison between European and North American guidelines on myocardial revascularization

Vein graft failure: current clinical practice and potential for gene therapeutics

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