12 research outputs found
Divalent metal inhibition of non-haem iron uptake across the rat duodenal brush border membrane
Real-time displacement and strain mappings of lithium-ion batteries using three-dimensional digital image correlation
Recent Strategies to Reduce Vein Graft Occlusion: a Need to Limit the Effect of Vascular Damage
AbstractDespite early identification and aggressive modification of atherosclerotic risk factors, many patients still require surgical revascularisation for established atherosclerotic vascular disease. However, bypass surgery is hampered by a high incidence of vein graft failure. New strategies are being introduced to improve these results, with early data suggesting that improved patency rates are possible. These vary from the use of adjuvant pharmacological agents and local gene transfer strategies to the modification of vein harvesting techniques in order to reduce vascular damage to all layers of the graft. Advances in vascular biology have resulted in new insights into the role of the endothelium and adventitia in vein graft remodelling. Although recent pharmacological adjuvant therapy and molecular techniques have been described that may be used to reduce the incidence of vein graft occlusion a more desirable approach for improved graft patency rates may be achieved simply by using atraumatic surgical techniques aimed at minimising vascular damage during vessel harvesting and subsequent anastamoses during bypass surgery
Detection of glucagon receptor mRNA in the rat proximal tubule: potential role for glucagon in the control of renal glucose transport
Human saphenous vein and coronary bypass surgery: ultrastructural aspects of conventional and “no-touch” vein graft preparations
Coronary artery bypass graft surgery
(CABG) is routinely used to restore blood flow to
diseased cardiac muscle due to coronary artery disease.
The patency of conventional grafts decreases with time,
which is due to thrombosis and formation of neointima.
A primary cause of graft failure is the mechanical
damage inflicted to the graft during harvesting, including
removal of surrounding tissue accompanied by high
pressure saline distension to overcome vasospasm (both
causing considerable mechanical trauma). The aim of
this study was to compare the ultrastructural features of
human saphenous vein (SV) grafts harvested
conventionally and grafts prepared using an atraumatic
‘no-touch’ harvesting technique introduced by Souza
(1996). The results of this study showed a better
preservation of the lumenal endothelium and medial
vascular smooth muscle (SM) in ‘no-touch’ versus
conventional grafts. A ‘fast’ (within 30 min) response of
SM cells to conventional harvesting was noted where
features of both SM cell division and apoptosis were
observed. It is concluded that the ‘preserved’ nature of
the ‘no-touch’ aortocoronary SV grafts renders them less
susceptible to thrombotic and atherosclerotic factors than
grafts harvested conventionally. These features are
suggested to contribute to the improved early patency
rate described using the no-touch technique of SV
harvesting