血管外支架预防静脉桥血管再狭窄的研究进展

Preventive effects of external stent on restenosis of vein grafts

冠状动脉旁路移植术 (CABG)后 ,静脉桥的再狭窄是亟需解决的问题。静脉桥管壁过度扩张导致管壁损伤 ,血管平滑肌细胞增生并向内膜迁移 ,内膜与中膜增厚 ,并在此基础上形成粥样斑块 ,是静脉桥晚期再狭窄的重要原因。静脉桥外放置血管外支架可限制管壁过度扩张 ,减轻管壁损伤 ,有效抑制增生的血管新内膜及内膜下泡沫细胞的形成 ,预防静脉桥的再狭窄 。

Coronary artery bypass grafting (CABG) with autologous saphenous vein is an established treatment for ischemic heart disease.However,its long-term clinical effects are limited.Late vein graft restenosis is the result of medial and intimal thickening consequent upon medial vascular smooth muscle cell migration,proliferation,followed later by superimposed atherosclerosis.Placing external stents around vein grafts can restrict its over-distention,reduce intimal and medial layer proliferation effectively,reduce the expression of vascular cell adhesion molecule-1(VCAM1),prevent the formation of foam cell,thus prevent late vein graft restenosis.External stent may be an applicable method to improve the long-term unobstruction of vein grafts.