Division of Vascular and Endovascular Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
J Vasc Surg. 2010 Mar;51(3):736-46. doi: 10.1016/j.jvs.2009.07.102. Epub 2009 Oct 17.
For patients with the most severe manifestations of lower extremity arterial occlusive disease, bypass surgery using autogenous vein has been the most durable reconstruction. However, the incidence of bypass graft stenosis and graft failure remains substantial and wholesale improvements in patency are lacking. One potential explanation is that stenosis arises not only from over exuberant intimal hyperplasia, but also due to insufficient adaptation or remodeling of the vein to the arterial environment. Although in vivo human studies are difficult to conduct, recent advances in imaging technology have made possible a more comprehensive structural examination of vein bypass maturation. This review summarizes recent translational efforts to understand the structural and functional properties of human vein grafts and places it within the context of the rich existing literature of vein graft failure.
对于下肢动脉闭塞性疾病症状最严重的患者，使用自体静脉的旁路手术一直是最持久的重建方法。然而，旁路移植狭窄和移植物失败的发生率仍然很高，通畅率也没有明显改善。一个潜在的解释是，狭窄不仅源于过度增生的内膜，还与静脉对动脉环境的适应或重塑不足有关。尽管进行人体体内研究较为困难，但影像学技术的最新进展使得对静脉旁路成熟的更全面的结构检查成为可能。本综述总结了理解人静脉移植物结构和功能特性的最新转化研究，并将其置于丰富的静脉移植物失败文献背景下。
