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graft restenosis

Sukhdeep Bhogal, Hemang B Panchal, Jayant Bagai, Subhash Banerjee, Emmanouil S Brilakis, Debabrata Mukherjee, Gautam Kumar, Madhan Shanmugasundaram, Timir K Paul
BACKGROUND: Drug eluting stents (DES) are preferred over bare metal stents (BMS) for native coronary artery revascularization unless contraindicated. However, the preferred stent choice for saphenous venous graft (SVG) percutaneous coronary interventions (PCI) is unclear due to conflicting results. METHODS: PubMed, Clinical trials registry and the Cochrane Center Register of Controlled Trials were searched through June 2018. Seven studies (n = 1639) comparing DES versus BMS in SVG-PCI were included...
November 22, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Lingchuang Bai, Jing Zhao, Qian Li, Jintang Guo, Xiangkui Ren, Shihai Xia, Wencheng Zhang, Yakai Feng
Artificial small-caliber vascular grafts are still limited in clinical application because of thrombosis, restenosis, and occlusion. Herein, a small-caliber vascular graft (diameter 2 mm) is fabricated from poly(ε-caprolactone)-b-poly(isobutyl-morpholine-2,5-dione) (PCL-PIBMD) and silk fibroin (SF) by electrospinning technology and then biofunctionalized with low-fouling poly(ethylene glycol) (PEG) and two cell-adhesive peptide sequences (CREDVW and CAGW) with the purpose of enhancing antithrombogenic activity and endothelialization...
November 28, 2018: Macromolecular Bioscience
Meena Archie, Hugh A Gelabert
INTRODUCTION: Subclavian artery aneurysms associated with thoracic outlet syndrome (TOS) have traditionally been managed by open surgical reconstruction. Endovascular subclavian artery reconstruction is novel in the setting of arterial TOS (aTOS). Our objective is to report our results with endovascular subclavian artery reconstruction in arterial TOS patients over a ten-year period with attention to surgical approach and late results. METHODS: Patients who underwent stent graft reconstruction of subclavian artery aneurysms associated with aTOS between 2006-2016 were identified in a prospective database...
November 23, 2018: Annals of Vascular Surgery
Daniel L Varela, Ehrin J Armstrong
Despite the development of new therapies for the treatment of femoropopliteal disease, nitinol stents remain a mainstay of therapy following balloon angioplasty. Consequently, femoropopliteal in-stent restenosis (FP-ISR) remains an important clinical problem. Interventions used to treat de novo lesions of the femoropopliteal segment have been used to treat ISR lesions, with disappointing outcomes. Early interventions focused on repeat balloon angioplasty, cryoplasty, and various debulking therapies. Recently, treatment has shifted towards the use of stent-grafts, drug-eluting therapies, and combination therapies...
November 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Luciano Barbato, Maria Antonietta Grasso, Salvatore Spagnolo
No abstract text is available yet for this article.
November 15, 2018: European Journal of Cardio-thoracic Surgery
Mathew Wooster, Blake Fernandez, Kelli L Summers, Karl A Illig
BACKGROUND: Subclavian vein stenosis or occlusion at the thoracic outlet is a problem associated with certain anatomic and environmental stresses (venous thoracic outlet syndrome [VTOS]), the presence of central venous catheters, and the high flows associated with arteriovenous (AV) access in the limb. We describe our experience with open and endovascular techniques for restoring patency in highly symptomatic patients. METHODS: A prospectively collected database of patients was queried for patients treated for central venous obstructive disease in the setting of highly symptomatic VTOS and ipsilateral AV access from October 2011 to August 2016...
November 12, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Kranthi K Kolli, James K Min
Coronary bypass grafting (CABG) is a surgical procedure for anastomosing small grafts to the coronary vessels. The bypass graft bridges the occluded or diseased coronary artery, allowing sufficient blood flow to deliver oxygen and nutrients to the heart muscles. Patient-specific (PS) anatomy obtained from coronary computed tomography angiography (CCTA) was used to generate a 3D aorto-coronary model (pre-surgery). Additionally, three more models with idealized grafts (individual and sequential grafts), were created using Boolean operations to represent post-surgery configuration...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Kang Xu, Mohanad Kh Al-Ani, Xin Pan, Qingjia Chi, Nianguo Dong, Xuefeng Qiu
Natural products are used widely for preventing intimal hyperplasia (IH), a common cardiovascular disease. Four different cells initiate and progress IH, namely, vascular smooth muscle, adventitial and endothelial cells, and circulation or bone marrow-derived cells. Vascular smooth muscle cells (VSMCs) play a critical role in initiation and development of intimal thickening and formation of neointimal hyperplasia. In this review, we describe the different originating cells involved in vascular IH and emphasize the effect of different natural products on inhibiting abnormal cellular functions, such as VSMC proliferation and migration...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
X Zhao, Q M Jing, Z F Wang, Y Han, X Z Wang, G Wang, Y L Han
Objective: To investigate the effect of excimer laser coronary atherectomy (ELCA) in the interventional treatment of acute coronary syndrome (ACS). Methods: This prospective study enrolled 31 patients with ACS who underwent ELCA treatment in our hospital from November 8, 2016 to December 13, 2017. The efficacy and complications of ELCA were observed, and patients were followed up for postoperative observation of major adverse cardiovascular and cerebrovascular events (including target vessel revascularization, stroke, stent thrombosis, coronary artery bypass grafting, and death)...
October 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Jeremy D Darling, Thomas F X O'Donnell, Sarah E Deery, Anthony V Norman, Giap H Vu, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Marc L Schermerhorn
OBJECTIVE: Historically, open surgical bypass provided a durable repair among diabetic patients with chronic limb-threatening ischemia (CLTI). In the current endovascular era, however, the difference in long-term outcomes between first-time revascularization strategies among patients with insulin-dependent diabetes mellitus (IDDM) is poorly understood. METHODS: We reviewed the records of all patients with IDDM undergoing a first-time infrainguinal bypass graft (BPG) or percutaneous transluminal angioplasty with or without stenting (PTA/S) for CLTI at our institution from 2005 to 2014...
November 2018: Journal of Vascular Surgery
Ron Waksman, Micaela Iantorno
PURPOSE OF REVIEW: This review will focus on our approach for the treatment of refractory in-stent restenosis. RECENT FINDINGS: The discovery of bare metal stents over three decades ago set a milestone in the evolution of percutaneous coronary intervention, which is currently the most widely performed procedure for the treatment of symptomatic coronary disease. However, the broad utilization of stents resulted in the new phenomenon of in-stent restenosis (ISR). Over the years, there has been an increase of the incidence of ISR despite continued improvement of drug-eluting stent (DES) technology...
October 22, 2018: Current Cardiology Reports
Li-Ying Huang, Ming-Chien Yang, Hui-Ming Tsou, Ting-Yu Liu
To solve the thrombosis and restenosis problem in cardiovascular stent implantation for cardiovascular artery disease, chondroitin 6-sulfate (ChS) with heparin (HEP) have been used as drug carrier layers and alternatively covalently bonded on gold (Au)-dimercaptosuccinic acid (DMSA)-thiolized cardiovascular metallic (SUS316 L stainless steel, SS) stents. Sirolimus, a model drug, was encapsulated in the ChS-HEP alternative layers. The behavior of the drug in releasing and suppressing the growth of smooth-muscle cells (SMCs) was evaluated with 5-layer CHS-HEP coating on the SS stents...
October 9, 2018: Colloids and Surfaces. B, Biointerfaces
Choongki Kim, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
Patient preference plays an important role in daily practice; however, its implication has not been well investigated regarding treatment strategy for complex coronary artery disease. We prospectively evaluated a trend of patient-centered decision-making of revascularization strategy in patients with multivessel or unprotected left main coronary artery disease. A standardized protocol that favors coronary artery bypass graft surgery (CABG) as the primary treatment of choice, rather than percutaneous coronary intervention, was adopted...
September 13, 2018: American Journal of Cardiology
Masaki Yamamoto, Miwa Tashiro, Tatsuya Noguchi, Kazumasa Orihashi
A 69-year-old woman with a history of graft replacement for abdominal aortic aneurysm developed a complicated type B aortic dissection that resulted in renal malperfusion after thoracic endovascular aortic repair (TEVAR). The primary entry tear was formed at the aortic arch and the false lumen (FL) continued to the abdominal aorta. The distal end of the FL formed a pouch-like blind alley above the suture line of the bifurcated abdominal graft. The true lumen (TL) was compressed and caused severe limb ischemia...
September 2018: Journal of Cardiology Cases
Shoudong Chai, Yang Yu, Haiming Li, Mingxin Gao, Li Bo, Chengxiong Gu
Vein graft remains the most broadly applied vascular material in coronary artery bypass surgery. However, the restenosis rate of the vein bridge following angioplasty is high. The present study investigated the effect of medical adhesive on vascular intimal hyperplasia, in addition to the signal transduction mechanism. A total of 36 New Zealand white rabbits were divided into three groups at random, including the normal group, the surgery group and the medical adhesive spray group. Following surgery for transplantation of the left external jugular vein to the ipsilateral common carotid artery for 4 weeks, the thickness and area of the intima and media of the vessel were measured on formalin‑fixed, paraffin wax‑embedded pathological sections using hematoxylin‑eosin staining, and alterations in the expression of proliferating cell nuclear antigen (PCNA), platelet endothelial cell adhesion molecule 1 (PECAM‑1), vascular cell adhesion protein 1 (VCAM‑1), extracellular signal‑regulated kinase (ERK)1/2, and endothelial nitric oxide synthase (eNOS) were detected by immunohistochemical staining, reverse transcription‑quantitative polymerase chain reaction analysis and western blotting...
September 17, 2018: Molecular Medicine Reports
Shan-Hui Hsu, Huey-Shan Hung
Treatment of cardiovascular disease has achieved great success using artificial implants, particularly synthetic-polymer made grafts. However, thrombus formation and restenosis are the current clinical problems need to be conquered. New biomaterials, modifying the surface of synthetic vascular grafts, have been created to improve long-term patency for the better hemocompatibility." The vascular biomaterials can be fabricated from synthetic or natural polymers for vascular tissue engineering. Stem cells can be seeded by different techniques into tissue-engineered vascular grafts in vitro and implanted in vivo to repair the vascular tissues...
September 13, 2018: Current Medicinal Chemistry
Marc Garbey, Stefano Casarin, Scott A Berceli
Peripheral arterial occlusive disease is a chronic pathology affecting at least 8-12 million people in the USA, typically treated with a vein graft bypass or through the deployment of a stent in order to restore the physiological circulation. Failure of peripheral endovascular interventions occurs at the intersection of vascular biology, biomechanics, and clinical decision making. It is our hypothesis that the majority of endovascular treatment approaches share the same driving mechanisms and that a deep understanding of the adaptation process is pivotal in order to improve the current outcome of the procedure...
August 9, 2018: Biomechanics and Modeling in Mechanobiology
Miguel Lemos Gomes, Alice Lopes, Gonçalo Sobrinho, Luis Mendes Pedro
Introduction: Renal venous graft restenosis is an uncommon event usually associated with significant clinical impact. Its treatment by endovascular stenting is seldom reported in the literature. Report: Two cases of successful stenting for restenosis in aorto-renal venous grafts are described, detailing the technique and in one case reporting for the first time the use of a covered stent in this condition. Discussion: Technical success may be achieved with proper material selection for the patient's anatomy and with dilation at relatively high pressures...
2018: EJVES Short Reports
Patrick Björkman, Tatu Kokkonen, Anders Albäck, Maarit Venermo
OBJECTIVE: Stenosis is a known complication in bypass vein grafts for peripheral arterial disease (PAD). The aim of this study was to evaluate the effect of drug-coated balloons (DCB) in the treatment of vein graft stenoses. SUMMARY BACKGROUND DATA: DCBs may prevent restenosis in arterial lesions. One small prospective, and larger retrospective and registry studies have failed to show benefit from DCBs in vein grafts. Prospective data are scarce. MATERIALS AND METHODS: 60 patients treated for primary or recurrent stenosis in venous bypass grafts were randomized to DCB (n=30) or standard balloon angioplasty (BA) (n=30)...
August 6, 2018: Annals of Vascular Surgery
Rahul Sharma, Michael Tradewell, Louis P Kohl, Ross F Garberich, Jay H Traverse, Anil Poulose, Emmanouil S Brilakis, Theresa Arndt, Timothy D Henry
BACKGROUND: A significant proportion of patients with complex, advanced coronary artery disease have refractory angina (RA) despite maximal pharmacological therapy and are deemed suboptimal candidates for revascularization. These patients are frequently termed "no-option" patients. However, despite this designation, many subsequently undergo coronary revascularization. We sought to determine the incidence, etiology and outcome of revascularization in "no-option" patients...
August 5, 2018: Catheterization and Cardiovascular Interventions
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