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Blood flow <120 mL has a good predictive value for early failure in RCAVF. During the procedure, this cut-off value may be used to select appropriately which RCAVF should be investigated in the operation theatre in order to correct in real time any abnormality.

The pathological remodeling of the venous wall, which leads to stenosis and ultimately graft failure, is the main limiting factor of human saphenous vein graft bypass. This remodeling is due to the hemodynamic adaptation of the vein to the arterial environment and cannot be prevented by conventional therapy. To develop a more targeted therapy, a better understanding of the molecular mechanisms involved in intimal hyperplasia is essential, which requires the development of ex vivo models of chronic perfusion of human veins.

The presence of Cx37 in the media layer of injured arteries restrains VSMC proliferation and limits the development of IH, presumably by interfering with the pro-proliferative effect of Cx43 and the Akt pathway.

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tissues, except at a very low concentration (0.044 ng/mg) in the liver, suggesting a very low risk 50 of systemic toxicity of locally delivered ATV. Additionally, the ex vivo data showed that ATV in 51 solution permeates through isolated human saphenous veins and thus is a good candidate for 52 perivascular delivery. 53Our data demonstrate that a local biphasic ATV release on the mice ligated carotid 54 efficiently prevents the development of IH without apparent toxicity. 55 56

Our study demonstrates that trans-peritoneal laparoscopy for treating median arcuate ligament syndrome is safe and feasible. Additional patients and a longer follow-up are needed for long-term assessment of this laparoscopic technique.