RESUMEN
Abstract The importance of the vasa vasorum and blood supply to the wall of human saphenous vein (hSV) used for coronary artery bypass grafting (CABG) is briefly discussed. This is in the context of the possible physical link of the vasa vasorum connecting with the lumen of hSV and the anti-ischaemic impact of this microvessel network in the hSV used for CABG.
Asunto(s)
Humanos , Vena Safena , Vasa Vasorum , Puente de Arteria Coronaria , Vena FemoralRESUMEN
The importance of the vasa vasorum and blood supply to the wall of human saphenous vein (hSV) used for coronary artery bypass grafting (CABG) is briefly discussed. This is in the context of the possible physical link of the vasa vasorum connecting with the lumen of hSV and the anti-ischaemic impact of this microvessel network in the hSV used for CABG.
Asunto(s)
Vena Safena , Vasa Vasorum , Puente de Arteria Coronaria , Vena Femoral , HumanosRESUMEN
Perivascular adipose tissue (PVAT) is a source of factors affecting vasomotor tone with the potential to play a role in the performance of saphenous vein (SV) bypass grafts. As these factors have been described as having constrictor or relaxant effects, they may be considered either beneficial or detrimental. The close proximity of PVAT to the adventitia provides an environment whereby adipose tissue-derived factors may affect the vasa vasorum, a microvascular network providing the vessel wall with oxygen and nutrients. Since medial ischaemia promotes aspects of graft occlusion the involvement of the PVAT/vasa vasorum axis in vein graft patency should be considered.
Asunto(s)
Tejido Adiposo , Vena Safena , Vasa Vasorum , Vena FemoralRESUMEN
Abstract Perivascular adipose tissue (PVAT) is a source of factors affecting vasomotor tone with the potential to play a role in the performance of saphenous vein (SV) bypass grafts. As these factors have been described as having constrictor or relaxant effects, they may be considered either beneficial or detrimental. The close proximity of PVAT to the adventitia provides an environment whereby adipose tissue-derived factors may affect the vasa vasorum, a microvascular network providing the vessel wall with oxygen and nutrients. Since medial ischaemia promotes aspects of graft occlusion the involvement of the PVAT/vasa vasorum axis in vein graft patency should be considered.
Asunto(s)
Vena Safena , Vasa Vasorum , Tejido Adiposo , Vena FemoralAsunto(s)
Distinciones y Premios , Vena Safena , Puente de Arteria Coronaria , Endoscopía , Arteria RadialRESUMEN
The saphenous vein (SV) is the most commonly used conduit for coronary artery bypass surgery (CABG) and the second conduit of choice in Brazil and many other countries. The radial artery (RA) is suggested, by some, to be superior to SV grafts, although its use in the USA declined over a 10 year period. The patency of SV grafts (SVG) is improved when the vein is harvested with minimal trauma using the no-touch (NT) technique. This improved performance is due to the preservation of the outer pedicle surrounding the SV and reduction in vascular damage that occurs when using conventional techniques (CT) of harvesting. While the patency of NT SVGs has been shown superior to the RA at 36 months in one study, data from the RADIAL trial suggests the RA to be the superior conduit. When additional data using NT SVG is included in this trial the difference in risk of graft occlusion between the RA and SV grafts dissipates with there no longer being a significant difference in patency between conduits. The importance of preserving SV structure and the impact of NT harvesting on conduit choice for CABG patients are discussed in this short review.
Asunto(s)
Puente de Arteria Coronaria/métodos , Enfermedad de la Arteria Coronaria/cirugía , Arteria Radial/trasplante , Vena Safena/trasplante , Brasil , Humanos , Metaanálisis como Asunto , Insuficiencia del Tratamiento , Grado de Desobstrucción VascularRESUMEN
Abstract The saphenous vein (SV) is the most commonly used conduit for coronary artery bypass surgery (CABG) and the second conduit of choice in Brazil and many other countries. The radial artery (RA) is suggested, by some, to be superior to SV grafts, although its use in the USA declined over a 10 year period. The patency of SV grafts (SVG) is improved when the vein is harvested with minimal trauma using the no-touch (NT) technique. This improved performance is due to the preservation of the outer pedicle surrounding the SV and reduction in vascular damage that occurs when using conventional techniques (CT) of harvesting. While the patency of NT SVGs has been shown superior to the RA at 36 months in one study, data from the RADIAL trial suggests the RA to be the superior conduit. When additional data using NT SVG is included in this trial the difference in risk of graft occlusion between the RA and SV grafts dissipates with there no longer being a significant difference in patency between conduits. The importance of preserving SV structure and the impact of NT harvesting on conduit choice for CABG patients are discussed in this short review.
Asunto(s)
Humanos , Vena Safena/trasplante , Enfermedad de la Arteria Coronaria/cirugía , Puente de Arteria Coronaria/métodos , Arteria Radial/trasplante , Grado de Desobstrucción Vascular , Brasil , Metaanálisis como Asunto , Insuficiencia del TratamientoRESUMEN
Critical limb ischaemia (CLI), due to atherosclerotic arterial occlusion, affects over 20,000 people per year in the United Kingdom with many facing lower limb amputation and early death. A role for endothelin-1 (ET-1) in atherosclerosis is well-established and increased circulating and tissue levels of this peptide have been detected in patients with CLI. ET-1 and its receptors were identified in atherosclerotic popliteal arteries obtained from CLI patients undergoing lower limb amputation. In addition, plasma ET-1 levels were compared with those of non-ischaemic controls. ET-1 was associated with regions of atherosclerotic plaque, particularly in regions with high macrophage content. This peptide was also associated with endothelial cells lining the main vessel lumen as well as adventitial microvessels. ET(A) and ET(B) receptors were located within regions of plaque, adventitial microvessels and perivascular nerves. There was a statistically significant increase (P < 0.001) in plasma ET-1 in CLI patients when compared with controls. These results reveal sources of ET-1 in atherosclerotic popliteal arteries that potentially contribute to increased circulating levels of this peptide. Identification of variable receptor distributions in ischaemic tissue suggests a therapeutic potential of selective receptor targeting in patients with CLI.