Hu Jia, Wan Song
Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People's Republic of China.
Asian Cardiovasc Thorac Ann. 2012 Oct;20(5):615-22. doi: 10.1177/0218492312456980.
Saphenous vein remains a widely used conduit in coronary surgery. However, the long-term success of surgical myocardial revascularization is largely limited by the development of neointimal hyperplasia and superimposed atherosclerosis in vein grafts. Although strategies for preventing vein graft failure have been constantly explored, few therapeutic interventions to date have shown sustained benefits in the clinical setting. The application of external support has emerged as a promising strategy for modulating the overall biomechanical responses in venous wall. Nonetheless, clinical translation of this intervention has been formerly challenged, primarily due to several technique limitations. The purpose of the current review is to summarize the possible mechanisms involved in the external support strategy for preventing vein graft failure. Furthermore, several previously tested biomaterials and delivery techniques are also highlighted.
大隐静脉仍是冠状动脉手术中广泛使用的血管移植物。然而,外科心肌血运重建的长期成功在很大程度上受到静脉移植物中新生内膜增生和叠加动脉粥样硬化发展的限制。尽管一直在探索预防静脉移植物失败的策略,但迄今为止,很少有治疗干预措施在临床环境中显示出持续的益处。外部支撑的应用已成为调节静脉壁整体生物力学反应的一种有前景的策略。尽管如此,这种干预措施的临床转化以前一直面临挑战,主要是由于一些技术限制。本综述的目的是总结外部支撑策略预防静脉移植物失败所涉及的可能机制。此外,还重点介绍了几种先前测试过的生物材料和递送技术。