Heng Elbert E, Wang Hanjay, Obafemi Oluwatomisin, Marsden Alison, Woo Y Joseph, Boyd Jack H
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA.
Vessel Plus. 2023;7. doi: 10.20517/2574-1209.2023.97. Epub 2023 Dec 14.
Saphenous vein grafts (SVGs) are the most widely used conduit in coronary artery bypass grafting (CABG) surgery; however, SVG failures due to neointimal hyperplasia present a significant long-term limitation to the effectiveness of myocardial revascularization. This review will provide a comprehensive overview of the biological mechanisms of vein graft failure, including compensatory endothelial proliferation, extracellular matrix deposition, and adventitial disruption. We will discuss historical and emerging strategies for vein graft failure prevention with a focus on the role of mechanical vein graft support using external stenting. Finally, we will highlight the results of preclinical and human trials and discuss future directions for investigation.
大隐静脉移植物（SVGs）是冠状动脉旁路移植术（CABG）中使用最广泛的血管 conduit；然而，由于内膜增生导致的 SVG 失败对心肌血运重建的有效性构成了重大的长期限制。本综述将全面概述静脉移植物失败的生物学机制，包括代偿性内皮细胞增殖、细胞外基质沉积和外膜破坏。我们将讨论预防静脉移植物失败的历史和新兴策略，重点关注使用外部支架进行机械静脉移植物支撑的作用。最后，我们将强调临床前和人体试验的结果，并讨论未来的研究方向。
