title: Coronary artery bypass graft: why is the saphenous vein prone to intimal hyperplasia?
abstract: Proliferation and migration of smooth muscle cells and the resultant intimal hyperplasia cause coronary artery bypass graft failure. Both internal mammary artery and saphenous vein are the most commonly used bypass conduits. Although an internal mammary artery graft is immune to restenosis, a saphenous vein graft is prone to develop restenosis. We found significantly higher activity of phosphatase and tensin homolog (PTEN) in the smooth muscle cells of the internal mammary artery than in the saphenous vein. In this article, we critically review the pathophysiology of vein-graft failure with detailed discussion of the involvement of various factors, including PTEN, matrix metalloproteinases, and tissue inhibitor of metalloproteinases, in uncontrolled proliferation and migration of smooth muscle cells towards the lumen, and invasion of the graft conduit. We identified potential target sites that could be useful in preventing and (or) reversing unwanted consequences following coronary artery bypass graft using saphenous vein.
authors.affiliation: a Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA.
authors.forename: Swastika
authors.initials: S
authors.lastname: Sur
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Sugimoto
authors.forename: Devendra K
authors.initials: DK
authors.lastname: Agrawal
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000209:etiology / Q000473:pathology; D002465:Cell Movement; D001026:Coronary Artery Bypass; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D008323:Mammary Arteries / Q000473:pathology; D020782:Matrix Metalloproteinases / Q000378:metabolism; D032389:Myocytes, Smooth Muscle / Q000378:metabolism / Q000473:pathology; D051059:PTEN Phosphohydrolase / Q000378:metabolism; D012501:Saphenous Vein / Q000378:metabolism / Q000473:pathology*; D013927:Thrombosis / Q000209:etiology / Q000473:pathology; D017539:Tunica Intima / Q000378:metabolism / Q000473:pathology*
chemical_list: D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human; D020782:Matrix Metalloproteinases
keywords: PTEN; coronary artery bypass graft; hyperplasie de l’intima; intimal hyperplasia; maladie du greffon veineux; matrix metalloproteinases; métalloprotéases de la matrice; pontage coronarien; vein-graft disease