Use of arterial grafts for coronary revascularization

Tomizawa, Yasuko; Endo, Masahiro; Nishida, Hiroshi; Niinami, Hiroshi; Tanaka, Satoshi; Tomioka, Haruaki; Ozawa, Hideki; Kikuchi, Chizuo; Koyanagi, Hitoshi

doi:10.1007/bf03218019

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…It is important to develop a model system to study stenosis in surgically injured arteries because surgical revascularization is the most important technique adopted with patients affected by severe or plurivessel coronary disease (Tomizawa et al, 1999). Coronary artery bypass grafts are often associated with endarterectomy in other districts, especially sovraaortic (Yamada et al, 1998).…”

Section: Resultsmentioning

confidence: 99%

“…At present, arterial conduits isolated from mammary, radial, epigastric and other arteries (Barner and Sundt, 1999) are used not only for the revascularization of coronary arteries, but also of iliac, carotid and femoral districts (Tomizawa et al, 1999). This procedure has been applied on atherosclerotic carotids of patients when the disease was not amenable to endarterectomy (Abou-Zamzam et al, 1999).…”

Section: Resultsmentioning

confidence: 99%

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Molecular analysis of arterial stenosis in rat carotids

et al. 2001

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A new model of surgical injury for the induction and development of stenosis in common rat carotids is described. This model differs from balloon angioplasty or vein graft systems currently applied on animals to develop stenosis, since it involves the entire vessel wall layers and mimics the injury occurring during arterial grafts, endarterectomy or organ transplantation. At different times following arterial damage, the pattern of expression of genes already known to be involved in the proliferation, differentiation, and apoptosis of smooth muscle cells (c-myc, Angiotensin II receptor 1, Bcl-2 and Bax alpha), as well as of Rb and Rb2 genes, whose pattern of expression after arterial injury has not yet been reported, was analyzed by semi-quantitative reverse transcription-polymerase chain reaction technique. Histological and histochemical analysis on carotid sections shows the morphological changes which occurred 30 days after surgical injury in the vessel wall. Molecular and histological data demonstrate that this model of surgical injury induces neointimal proliferation in about 30% of rats. In about 70% of the remaining rats, it induces the processes responsible for negative remodelling, namely the significant accumulation of extracellular matrix and fibers and disorganization of arterial tunics. This model is therefore available for further studies on the expression of genes involved in the arterial stenotic process, as well as for testing drugs aimed at limiting this recurrent pathophysiological phenomenon.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Molecular analysis of arterial stenosis in rat carotids

et al. 2001

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“…Mainly, an angiogram was performed unilaterally on the left IMA, and the "distal diameter" of the IMA was measured at the level of the sixth intercostal space because the sizes of right and left IMAs are recognized to be almost the same. 4 The use of small grafts was avoided, and the lower limit was a distal diameter of 1.6 mm for IMA and 1.7 mm for GEA. In patients with diabetes (treated with or without insulin), advanced age, or left ventricular dysfunction, BIMA was used without hesitation for elective CABG.…”

Section: Patientsmentioning

confidence: 99%

Benefit of bilateral over single internal mammary artery grafts for multiple coronary artery bypass grafting

Endo¹,

Nishida²,

Tomizawa³

2002

ACC Current Journal Review

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Background-The aim of this study was to evaluate the performance of bilateral internal mammary artery (BIMA) grafts in isolated CABG. Methods and Results-Beginning in April 1985, elective primary multiple CABG for multivessel disease was performed in 1131 patients. The early and late results of 688 patients who received single internal mammary artery (SIMA) grafts and 443 patients who received BIMA grafts were compared (median follow-up, 6.15 years). Hospital mortality was not significantly different in the SIMA (0.9%) and BIMA (0.9%) groups. Graft patency was 97.3% in the BIMA group and 94.3% in the SIMA group (PϽ0.0001). The 7-year repeated CABG-free rate was significantly higher in the BIMA group (Pϭ0.026). The 7-year new myocardial infarction-free rate in all patients tended to be higher in the BIMA group (Pϭ0.06). The hazard ratio for all death or repeated CABG in patients with ejection fractions Ͼ0.4 and age Ͻ71 years was lower in the BIMA group (Pϭ0.0499). Conclusions-Our data suggest that the use of BIMA grafts in patients with in situ coronary artery anastomoses achieves a significantly higher repeated CABG-free rate in all patients compared with the use of SIMA. (Circulation. 2001;104: 2164-2170.)

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“…Although internal thoracic artery has lower incidence of atherosclerosis than other arterial grafts [4,16], the presence of calcification and other atherosclerotic manifestations can be found in ITA grafts as well [17]. Oxidative and nitrosative stress play an important role in the pathogenesis of atherosclerosis [18–20].…”

Section: Introductionmentioning

confidence: 99%

Human internal thoracic artery grafts exhibit severe morphological and functional damage and spasmic vasomotion due to oxidative stress

et al. 2011

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SummaryBackgroundThe internal thoracic artery (ITA) is the first choice for myocardial revascularization, but atherosclerotic lesions and perioperative vasospasm may still limit its functionality. Oxidative stress via the peroxynitrite – poly-(ADP-ribose) polymerase (PARP) cascade plays an important role in the pathogenesis of impaired vascular tone via endothelial injury. We aimed to investigate and describe the histology, PARP activation and functionality of ITA grafts and to assess the possible beneficial effect of PARP-inhibition.Material/MethodsITA specimens from 47 patients (26 men, mean age 66.2±1.7 years) who underwent coronary bypass surgery were processed for histological and immunohistochemical studies for oxidative stress and PARP activation, and were functionally tested with acetylcholine (ACh) and sodium nitroprusside (SNP) with or without PARP inhibition.ResultsThe sections showed atherosclerotic alterations and oxidative and nitrosative stress were evidenced by positive 3-nitrotyrosine, 4-hydroxynonenal and PAR stainings. Functionally, 88.1% reacted to K-Krebs, 68.7% exhibited contraction after 1 μM phenylephrine, 29.9% exhibited relaxation to 30 μM Ach, and all precontracted segments relaxed to 30 μM SNP. High amplitude vasomotion was observed in 47.8% of the segments, which could be abolished by the application of 10 μM SNP. Incubation of the preparations with PJ34 did not improve endothelium-dependent vasodilation.ConclusionsITA grafts are severely damaged both morphologically and functionally in patients undergoing coronary artery bypass surgery, but PARP inhibition cannot improve their functional characteristics. The topical use of SNP to the ITA during the operation may improve vascular functions by dilating the vessels and eliminating the eventual spasmic vasomotion.

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Use of arterial grafts for coronary revascularization

Cited by 11 publications

References 10 publications

Molecular analysis of arterial stenosis in rat carotids

Molecular analysis of arterial stenosis in rat carotids

Benefit of bilateral over single internal mammary artery grafts for multiple coronary artery bypass grafting

Human internal thoracic artery grafts exhibit severe morphological and functional damage and spasmic vasomotion due to oxidative stress

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