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Fashina O, Abbasciano RG, McQueen LW, Ladak S, George SJ, Suleiman S, Punjabi PP, Angelini GD, Zakkar M. Large animal model of vein grafts intimal hyperplasia: A systematic review. Perfusion 2022:2676591221091200. [PMID: 35624557 DOI: 10.1177/02676591221091200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Coronary artery bypass grafting remains the treatment of choice for a large cohort of patients with significant coronary disease. Despite the increased use of arterial grafts, the long saphenous vein remains the most commonly used conduit. Long-term graft patency continues to be the Achilles heel of saphenous vein grafts. This is due to the development of intimal hyperplasia, a chronic inflammatory disease that results in the narrowing and occlusion of a significant number of vein grafts. Research models for intimal hyperplasia are essential for a better understanding of pathophysiological processes of this condition. Large animal models resemble human anatomical structures and have been used as a surrogate to study disease development and prevention over the years. In this paper, we systematically review all published studies that utilized large animal models of vein graft disease with a focus on the type of model and any therapeutic intervention, specifically the use of external stents/mesh.
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Affiliation(s)
- Oluwatomini Fashina
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Riccardo G Abbasciano
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Liam W McQueen
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Shameem Ladak
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Sarah J George
- Bristol Heart Institute and Translational Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Bristol, UK
| | - Sadeeh Suleiman
- Bristol Heart Institute and Translational Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Bristol, UK
| | - Prakash P Punjabi
- Department of Cardiovascular Sciences, Imperial College, Hammersmith Hospital, London, UK
| | - Gianni D Angelini
- Bristol Heart Institute and Translational Biomedical Research Centre, Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Bristol, UK
| | - Mustafa Zakkar
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
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Pathophysiological features of intimal hyperplasia of the arterially implanted autovein graft and its anastomosis in dogs. Int J Angiol 2011. [DOI: 10.1007/bf01618389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Shergold OA, Fleck NA. Experimental Investigation Into the Deep Penetration of Soft Solids by Sharp and Blunt Punches, With Application to the Piercing of Skin. J Biomech Eng 2005; 127:838-48. [PMID: 16248314 DOI: 10.1115/1.1992528] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An experimental study has been conducted on the penetration of silicone rubbers and human skin in vivo by sharp-tipped and flat-bottomed cylindrical punches. A penetrometer was developed to measure the penetration of human skin in vivo, while a conventional screw-driven testing machine was used to penetrate the silicone rubbers. The experiments reveal that the penetration mechanism of a soft solid depends upon the punch tip geometry: a sharp tipped punch penetrates by the formation and wedging open of a mode I planar crack, while a flat-bottomed punch penetrates by the growth of a mode II ring crack. The planar crack advances with the punch, and friction along the flanks of the punch leads to a rising load versus displacement response. In contrast, the flat-bottomed punch penetrates by jerky crack advance and the load on the punch is unsteady. The average penetration pressure on the shank cross section of a flat-bottomed punch exceeds that for a sharp-tipped punch of the same diameter. In addition, the penetration pressure decreases as the diameter of the sharp-tipped punch increases. These findings are in broad agreement with the predictions of Shergold and Fleck [Proc. R. Soc. London, Ser. A (in press)] who proposed models for the penetration of a soft solid by a sharp-tipped and flat-bottomed punch.
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Affiliation(s)
- Oliver A Shergold
- Department of Engineering, Cambridge University, Trumpington Street, Cambridge, CB2 1 PZ, UK
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Shiroma H, Kusaba A. Ultrastructural features of progressive intimal hyperplasia at the distal end-to-side anastomosis of vein grafts. CARDIOVASCULAR SURGERY (LONDON, ENGLAND) 1996; 4:393-8. [PMID: 8782945 DOI: 10.1016/0967-2109(95)00081-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The features of intimal hyperplasia at the distal end-to-side anastomosis of arterially implanted autovein bypass grafts in dogs were examined using light and transmission electron microscopy. The bypass grafting was done under conditions of reduced blood flow with an abnormal flow wave and high peripheral resistance. Anastomotic intimal hyperplasia was evident 14 to 31 days after implantation, then gradually increased, particularly at the toe portion of the anastomosis. From 6 to 12 months after implantation, the intimal hyperplasia was excessively increased and severe luminal stenosis had developed. The hyperplastic neointima consisted of two layers; a laminated superficial layer and a randomly arranged deeper layer. The superficial layer had three to four layers of smooth muscle cells, while the deeper layer was mostly fibrocollagenous tissues. Thus, the intimal hyperplasia at the distal end-to-side anastomosis of the arterially implanted autovein graft developed as a result of infiltration of fibroblast-like cells, presumably tissue-synthesizing mesenchymal cells. The neointima at the distal anastomosis, under conditions of reduced blood flow with high peripheral resistance, remained in an active phase of intimal hyperplasia even 12 months after bypass grafting.
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Affiliation(s)
- H Shiroma
- Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
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Self-assessment quiz. Surg Today 1993. [DOI: 10.1007/bf00309515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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