Pathophysiology of saphenous vein graft failure: a brief overview of interventions.
Coronary artery bypass graft surgery (CABG) is widely used for the treatment of atheromatous stenosis of coronary arteries. However, as many as 50% of grafts fail within 10 years after CABG due to neointima (NI) formation, a process involving the proliferation of vascular smooth muscle cells (VSMCs) and superimposed atherogenesis. To date no therapeutic intervention has proved successful in treating late vein graft failure. However, several diverse approaches aimed at preventing neointimal formation have been devised which have yielded promising results. In this review, therefore, we will summarise the pathophysiology of vein graft disease and then briefly consider interventional approaches to prevent late vein graft failure which include surgical technique, conventional pharmacology, external sheaths, cytostatic drugs and gene transfer.
Bristol Heart Institute, The University of Bristol, UK. n.shukla@bris.ac.uk
Nilima
N
Shukla
Jamie Y
JY
Jeremy
D000818:Animals; D001026:Coronary Artery Bypass; D054697:Cytostatic Agents / Q000627:therapeutic use; D054855:Drug-Eluting Stents; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D015316:Genetic Therapy; D006083:Graft Occlusion, Vascular / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D058426:Neointima / Q000503:physiopathology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012501:Saphenous Vein / Q000637:transplantation*; D013927:Thrombosis / Q000503:physiopathology / Q000517:prevention & control
D054697:Cytostatic Agents; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors