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Results for “Vascular Patency”

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At least 19 recordsLinked to original sources
PubMed1976

Factors influencing postoperative vascular patency.

In summary, we have briefly examined the pathogenesis of arterial thrombosis, the importance of vessel wall injury and alteration of blood flow in this process, and finally the rationale for use of various agents in an attempt to promote postoperative vascular patency. At present, as in the past, the most important factor toward ensuring patency after arterial reconstruction is a technically perfect operation which allows vigorous inflow and runoff and rapid linear flow (25).

Blood Vessels↗
PubMed1977

Correlation of myocardial contraction band necrosis and vascular patency. A study of coronary artery bypass graft anastomoses at branch points.

Eleven patients who died within 1 week of operation and in whom saphenous vein bypass graft anastomoses were located at or extended across coronary artery branch points were studied at autopsy. New surgically introduced narrowings of greater than 75% in one branch of the 13 anastomoses studied were more frequent (six of eight) when the arteriotomy extended into a branch artery than when the arteriotomy ended proximal to the flow divider of the branch point (zero to five). Obstruction was most frequently caused by suture compression of the arterial lumen. In five of the six anastomoses, where one branch contained a significant new narrowing and the other did not, a striking difference in the severity of myocardial contraction band necrosis in the distribution of the two arteries was found. In each such case the severe necrosis was in the distribution of the patent branch artery and the obstructed branch had slight or trivial injury. The results are interpreted as showing that myocardium that has the potential for developing contraction band necrosis may not develop it if the reflow phase is suppressed.

Adult↗
PubMed1977

Improvement in experimental vascular graft patency by controlled defibrinogenation.

A sensitive animal model was used to investigate treatment designed to improve vascular graft patency. A Dacron graft was inserted into the infrarenal vena cava of 30 rabbits. Half were treated with subcutaneous Arvin for 28 days after operation. This produced a significant lowering of the post operative plasma fibrinogen. The patency rate of the grafts in the treated rabbits was significantly greater than in the control rabbits.

Ancrod↗
PubMed1978

Revascularized periosteal grafts--a new method to produce functional new bone without bone grafting.

Rib periosteum was transplanted to the groins of 9 dogs. In half of the periosteal grafts, no microvascular anastomoses were done (free grafts); at 6 weeks after grafting they had become resorbed. The other periosteal grafts were revascularized by microvascular anastomoses of the intercostal vessels to local muscular vessels; at 6 weeks those with confirmed vascular patency had all formed substantial amounts of new bone. Five cm, full-thickness defects were created in the tibias of 10 dogs. The control animals (without grafting) did not heal in two months. However, the experimental dogs, with vascularized periosteal grafts in the defects regenerated their tibias with healthy new bone by 6 weeks--and were walking on them then.

Animals↗
PubMedDate not supplied

Real time ultrasound tomography of the adult brain.

Initial clinical results are reported from a new real time, 2-dimensional ultrasound scanner modified for adult cephalic applications. An optimized transducer design and the use of the dynamically focused phased array imaging system have resulted in ultrasound tomograms of the brain which are significant improvements over previous attempts. Horizontal and coronal images of the ventricles, the corpus callosum and other midline structures are routinely displayed in a 45 degrees sector format. In addition, pulsating cerebral arteries are displayed in real time. Quantitative information can be obtained concerning cerebral vascular patency by using the selectable M-mode feature of this system. The results indicate that real time ultrasound tomography has potential for clinical application.

Adult↗
PubMed1979

A study of irradiated bone: I. histopathologic and physiologic changes.

Histologic and tracer techniques were used to investigate and document alterations in bone pathophysiology subsequent to irradiation of the left hind limb of rabbits. Numerous time-dependent changes were observed. Among these were an inflammatory response shortly after irradiation, and an increase in the remodeling of cortical bone, which peaked between 3 and 6 mo after irradiation. The changes in bone remodeling correlated with changes in vascular patency in a manner consistent with the hypothesis that radiation damage in mature bone is mediated primarily through alterations in the fine vasculature. The findings of this study provide important information on the time course of changes in bone pathophysiology following regional irradiation. They are used in the second of this series of papers to help establish which mechanisms are responsible for postirradiation alterations in the localization of Tc-99m pyrophosphate in these rabbits.

Animals↗
PubMed1975

The effect of continued cigarette smoking on the patency of synthetic vascular grafts in Leriche syndrome.

The effects of continued smoking were studied in 187 consecutive patients who underwent aorto-iliac or aorto-femoral grafting because of Leriche disease and who left the hospital with well-functioning grafts. The patients were divided into the following groups: (1) never smoked, (2) stopped smoking after the operation, (3) continued to smoke less than a pack a day and (4) continued to smoke more than a pack a day. The patency of the grafts was evaluated at regular intervals during a follow-up period ranging from 6 months to 10 years. A significant difference in the patency in the favor of the nonsmokers was found, with the "more than one pack a day" group having more than triple the occlusion rate of the nonsmokers, both absolutely and in month-patency time. We recommend that the surgeon make a most sincere effect to induce patients undergoing vascular operations for occlusive vascular diseases to give up smoking. Failure to promise to stop the smoking habit should be regarded as a relatively strong contraindication for surgery in patients not directly threatened with loss of an extremity.

Arteriosclerosis↗
PubMed1978

Compliance as a factor effecting the patency of a copolyurethane vascular graft.

A new solid-wall vascular graft which has a compliance approximating that of the natural artery has been prepared from a copolyether-urethane material. Six of nine of these compliant grafts implanted in dogs were patent on removal, the longest implant time being 77 days for a 4-mm I.D. femoral artery graft. This is in contrast to noncompliant grafts of the same copolyurethane in which failure usually occurred within 48 hr.

Animals↗
PubMed2026

Adaptive proteomic remodeling and eNOS upregulation in luminal endothelium and perivascular adipose tissue of patent saphenous vein grafts after CABG.

OBJECTIVE: Long-term patency of saphenous vein grafts (SVGs) remains a significant challenge in coronary artery bypass grafting (CABG). The biological factors underlying successful human grafts are poorly understood. We aimed to characterize the structural and molecular features associated with successful graft function. METHODS: Patent and occluded SVG and internal thoracic artery (ITA) grafts were obtained from explanted hearts of CABG patients undergoing heart transplantation for end-stage heart failure not attributable to graft failure, along with freshly harvested ITA and SVG controls. Samples underwent histomorphological analysis, immunohistochemistry (IHC), and liquid chromatography-tandem mass spectrometry (LC-MS/MS) proteomics. RESULTS: Patent ITA (ITA-P) showed minimal intimal hyperplasia with medial reinforcement, whereas patent SVGs (SVG-P) had organized, α-smooth muscle actin (αSMA)-positive myofibroblast-rich neointima. Endothelial nitric oxide synthase (eNOS) was markedly upregulated in patent grafts at two sites-the luminal endothelium and adventitial microvessels within perivascular adipose tissue (PVAT)-and lost at both sites in occluded SVG (SVG-O). Adventitial CD31-positive microvessels were significantly increased in patent grafts. Proteomically, ITA-P and SVG-P shared a largely common adaptive proteome enriched in translation, RNA processing, and extracellular matrix (ECM) organization, with shared upstream activation of NR4A3, EGFR, and STAT1, and conduit-specific signatures (IGF-1/RUNX2 in ITA-P; RETN/SRC/PTGES in SVG-P). PTGES was strongly expressed in the adventitia of SVG-P. CONCLUSIONS: Patent arterial and venous bypass grafts exhibited a shared adaptive phenotype characterized by dual-site upregulation of eNOS in both the luminal endothelium and the perivascular microvessels/PVAT. In SVG-P, PTGES was co-upregulated alongside eNOS, indicating a mechanistic link between the proteomic and IHC findings. These findings highlight the perivascular compartment as a site of adaptive, eNOS-associated changes in patent vein grafts.

Humans↗
PubMed1978

[Uses in vascular symptomatology of the ultrasonic flowmeter with Doppler effect in patients revascularized for peripheral obliterating arteritis].

The Authors present 38 cases of surgical revascularization for arteriosclerosis obliterans of the lower extremities, operated in Clinica Chirurgica of Ancona during the space of three Years, from 1974-1977. The morphological profile of the sphygmic wave and pressures of occlusion or Travis Winsor's index were studied pre and postoperatively with Doppler ultrasonic flowmeter. The patency of vascular grafts and after thromboendarterectomy was shown by T.W.'s index. With this method, besides establishing a program for postoperative arteriography, a lesser use of the latter was shown.

Arteriosclerosis Obliterans↗
PubMed2026

Physician-Modified Fenestrated Stent-Grafts Planned Using Three-Dimensional Techniques for Complex Aortic Pathology: A Systematic Review and Meta-Analysis.

BACKGROUND: Complex aortic pathology involving the visceral arteries remains a significant therapeutic challenge. Open repair is associated with considerable perioperative risk, particularly in patients with multiple comorbidities, while standard endovascular aneurysm repair (EVAR) is often not feasible because of inadequate proximal sealing zones. Fenestrated and branched endovascular repair (F/BEVAR) represents an established treatment strategy; however, the use of custom-made devices is limited by manufacturing time and availability. Physician-modified stent grafts (PMSGs) have therefore emerged as a pragmatic alternative. Three-dimensional planning techniques have been increasingly used to facilitate accurate graft modification. The aim of this systematic review and meta-analysis was to evaluate the effectiveness and safety of PMSG procedures planned with three-dimensional techniques. Technical success, target vessel patency, early mortality, endoleak occurrence, and reintervention rates were analyzed. METHODS: A systematic search was conducted in the PubMed/MEDLINE and Embase databases. Studies describing the use of physician-modified fenestrated stent grafts planned with three-dimensional tools were included. Meta-analyses were performed using a random-effects model with restricted maximum likelihood estimation. A logit transformation was used for the analysis of proportions. RESULTS: The analysis included five studies involving 172 patients. The estimated weighted mean follow-up duration was 14.9 months. The overall technical success rate was 92.9% (95% confidence interval [CI]: 84.5-96.9%), with low-to-moderate heterogeneity. Target vessel patency was 96.9% (95% CI: 93.6-98.5%). Early mortality was 5.5% (95% CI: 2.1-13.3%). The incidence of endoleaks was 13.3% (95% CI: 5.8-27.4%), with significant heterogeneity among studies. Reinterventions were reported in 6.6% of patients (95% CI: 2.3-17.5%). CONCLUSION: The results indicate that PMSG procedures planned with three-dimensional techniques are associated with a high rate of technical success and preserved patency of target vessels in patients with complex aortic pathology. The observed variability in endoleak and reintervention rates likely reflects differences in anatomical complexity and patient selection among studies. Further prospective studies are needed to confirm long-term outcomes.

Humans↗
PubMed2026

Efficacy and Safety of Autologous Versus Prosthetic Grafts in the Repair of Popliteal Artery Aneurysms: A Systematic Review and Meta-Analysis.

BACKGROUND: Popliteal artery aneurysms (PAAs) present a severe risk of progression to acute limb ischemia. Open surgery (OS) is the gold standard treatment; however, prosthetic grafts are acceptable in highly selected cases, especially when the great saphenous vein is not available. METHODS: We performed a systematic review and meta-analysis of studies comparing autologous versus prosthetic grafts for patency and limb preservation outcomes in patients with PAAs. MEDLINE, Embase, and Cochrane Central were systematically searched from inception through October 2024. Outcomes were pooled using a frequentist random-effects model as odds ratios, mean differences, and hazard ratios (HRs) with 95% confidence intervals (CIs) on RStudio (Version 4.5.0). Risk-of-bias assessments were performed using ROBINS-I and MINORS. RESULTS: Twenty-two observational studies were pooled comprising 9,145 PAAs in 8,370 patients, of whom 6,434 (74.51%) were treated with autologous grafts and 2,200 (25.49%) with prosthetic grafts. Follow-up ranged from 12 to 86 months. Repair with autologous conduits significantly improved long-term primary patency (HR 3.93; P < 0.001), secondary patency (HR 6.02; P < 0.001), and long-term limb salvage (HR 2.69; P = 0.044) compared with prosthetic conduits. There were no significant differences in in-hospital amputation (P = 0.36), myocardial infarction (P = 0.61), mortality (P = 0.50), 2-year primary patency (P = 0.25), 5-year secondary patency (P = 0.06), or length of hospital stay (P = 0.95). Risk of bias was classified as moderate-to-high, reflecting confounding factors inherent to observational studies and moderate methodological quality by MINORS. Despite these limitations, treatment effects consistently favored autologous grafts in both short- and long-term analyses; however, caution is warranted given the limited number of available studies. CONCLUSION: The use of autologous conduits significantly favors both short-term and long-term efficacy and safety in the OS repair of PAAs. Given the limitations of the existing evidence, further comparative studies are needed.

Humans↗
PubMed1979

Thrombogenic potential of dacron grafts after prior exposure to whole blood, plasma, or albumin.

On hundred forty six (146) vascular graft insertions have been examined to determine the best exposure media, the mode of exposure, and the time of exposure required to change the TP of knitted dacron fabric. Whole blood, plasma, albumin, and Ringer's lactate (as control) were the media used. The mode of exposure was by either simple soaking or physiological perfusion with the appropriate media. The time of exposure was from one hour to 7 days. Simple soaking in species-specific albumin was found to be highly effective in lowering the TP of knitted dacron and we advocate this as the initial step in preclotting dacron grafts. This step is equally critical in the smaller vascular replacements and should lead to improved patency of these dacron vascular grafts.

Animals↗