The natural history of intermediate and critical vein graft stenosis: Recommendations for continued surveillance or repair

Mills, Joseph L.; Wixon, Christopher L.; James, Donovan C.; Devine, Jenifer; Westerband, Alex; Hughes, John D.

doi:10.1067/mva.2001.112701

Cited by 102 publications

(76 citation statements)

References 43 publications

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“…The positive impact of surveillance imaging programs on graft patency has also been recognized. 16 One can assume that the introduction of better interventional techniques, lower-profile equipment, and more reliable periprocedural anticoagulant therapies in recent years has probably lessened the likelihood of iatrogenic arterial injury and distal embolization. Although conjectural, all of these measures have likely contributed collectively to the decline in LET incidence.…”

Section: Discussionmentioning

confidence: 99%

Twenty-Year Analysis of Trends in the Incidence and In-Hospital Mortality for Lower-Extremity Arterial Thromboembolism

et al. 2013

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Background-Epidemiology data for lower-extremity arterial thromboembolism (LET) are limited and may result from either acute limb ischemia or an acute exacerbation of critical limb ischemia. Given marked changes in both diagnosis and therapy over the last 2 decades, we hypothesized that this time period would have witnessed reductions in both the incidence and in-hospital mortality of LET. Methods and Results-Data from 1988 through 2007 from the National Hospital Discharge Survey were analyzed. All admissions for patients with LET were extracted, and the respective International Classification of Diseases, Ninth Revision, Clinical Modification codes were internally validated for both LET and acute limb ischemia. Descriptive statistics were used. The validity of the codes was good for identifying LET cases but poor for identifying acute limb ischemia cases because many of these acute presentations were attributable to critical limb ischemia. Over the 20-year span, there were 1.76 million cases of LET. The incidence of LET decreased significantly from 42.4 per 100 000 persons between 1988 and 1997 to 23.3 per 100 000 persons between 1998 and 2007. The in-hospital mortality for LET decreased significantly from 8.28% between 1988 and 1997 to 6.34% between 1998 and 2007, and male patients achieved greater mortality reduction compared with female patients. Treatments for acute limb ischemia showed decreasing use of surgical bypass and amputation and increasing rates of catheter-based thrombolysis. Conclusions-Over the 20-year study period, there have been significant reductions in both LET incidence and in-hospital mortality. Unfortunately, LET admissions extracted from an administrative database comprise a diverse group of individuals, including those with acute and chronic forms of limb ischemia and iatrogenic arterial injury, limiting the true assessment of ALI incidence. .).The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

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Section: Discussionmentioning

confidence: 99%

Twenty-Year Analysis of Trends in the Incidence and In-Hospital Mortality for Lower-Extremity Arterial Thromboembolism

et al. 2013

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“…Moreover, surveillance Duplex ultrasound has acquired an important role in the postoperative assessment of patients following lower extremity revascularization. It enables prompt detection of hemodynamically significant lesions and early intervention (Bandyk, 2002, Mills et al, 2001. Patients undergoing EVAR (endovascular aneurysm repair) are also monitored by serial ultrasound examinations (Bendick et al, 2003;Carter et al, 2000;McWilliams et al, 1999;Pearce & Astleford, 2004).…”

Section: Intra-operative and Post-operative Ultrasoundmentioning

confidence: 99%

Ultrasound Imaging in Vascular Diseases

Fragou¹,

Karabinis²,

Daphnis³

et al. 2011

Ultrasound Imaging - Medical Applications

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“…Although the acute survival rate of vein grafts is high, the long-term patency is not satisfactory, especially for peripheral vein grafts where a high incidence of vein graft disease is present and 30% of infra-inguinal grafts fail in 2 years [1]. Endothelial denudation is regarded as an important initial injury that induces acute inflammation and allows neointima hyperplasia to proceed [2,3].…”

Section: Introductionmentioning

confidence: 99%

Inhibition of Inducible Nitric Oxide Synthase Promotes Vein Graft Neoadventitial Inflammation and Remodelling

Wadsworth

Kennedy

2010

J Vasc Res

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Background: Grafting veins into the arterial circulation causes endothelial damage and neointimal hyperplasia. However, the remodelling of vein grafts and the contribution of the endothelium is not well understood. Since nitric oxide (NO) has a crucial role in vascular function, we investigated the importance of NO synthases (NOSs) in vein graft re-endothelialization and remodelling in this study. Methods and Results: Mouse isogenic vena cava was grafted into the carotid artery. Progressive remodelling of the grafted veins was evidenced by re-endothelialization at 2 weeks and subsequent appearance of vasomotor function at 4 weeks. Pharmacological inhibition of inducible NOS (iNOS) with the specific inhibitor 1400W, administered between 2 and 4 weeks after grafting, when re-endothelialization was complete, resulted in neoadventitial inflammation, neoadventitial thickening and impaired functional remodelling. Conclusion: Completion of re-endothelialization is pivotal in vein graft remodelling in the mouse and is associated with a series of changes in inflammation, proliferation and initiation of vascular functional remodelling. After re-endothelialization, iNOS upregulation may be an important mechanism to prevent secondary neoadventitial inflammation and preserve ongoing functional remodelling. iNOS activity could therefore be beneficial for long-term patency of the vein graft.

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The natural history of intermediate and critical vein graft stenosis: Recommendations for continued surveillance or repair

Cited by 102 publications

References 43 publications

Twenty-Year Analysis of Trends in the Incidence and In-Hospital Mortality for Lower-Extremity Arterial Thromboembolism

Twenty-Year Analysis of Trends in the Incidence and In-Hospital Mortality for Lower-Extremity Arterial Thromboembolism

Ultrasound Imaging in Vascular Diseases

Inhibition of Inducible Nitric Oxide Synthase Promotes Vein Graft Neoadventitial Inflammation and Remodelling

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