Large animal model of vein grafts intimal hyperplasia: A systematic review
Oluwatomini Fashina1, Riccardo G Abbasciano1, Liam W McQueen1
1Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK.
Insights
Large animal models are crucial for studying vein graft disease, specifically intimal hyperplasia, to improve long-term graft patency after coronary artery bypass grafting surgery.
Area of Science:
- Cardiovascular Surgery
- Vascular Biology
- Biomedical Engineering
Background:
- Coronary artery bypass grafting (CABG) is a primary treatment for coronary artery disease.
- Saphenous vein grafts are widely used but suffer from poor long-term patency due to intimal hyperplasia.
- Intimal hyperplasia, a chronic inflammatory condition, leads to vein graft narrowing and occlusion.
Approach:
- This study systematically reviews literature on large animal models used to study vein graft disease.
- The review focuses on the types of animal models employed and therapeutic interventions investigated.
- Special attention is given to the use of external stents or mesh as a therapeutic strategy.
Key Points:
- Large animal models offer anatomical similarities to humans, making them valuable for disease research.
- Understanding intimal hyperplasia pathophysiology is key to improving vein graft outcomes.
- External stents/mesh represent a potential therapeutic avenue for preventing vein graft failure.
Conclusions:
- Large animal models are indispensable tools for elucidating the mechanisms of vein graft intimal hyperplasia.
- Further research using these models can guide the development of effective strategies to enhance graft patency.
- Investigating interventions like external stenting is critical for advancing CABG surgical success.
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.
