Vascular pharmacology
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Vascular pharmacology · Mar 2013
Review Comparative Study'No-touch' saphenous vein harvesting improves graft performance in patients undergoing coronary artery bypass surgery: a journey from bedside to bench.
The saphenous vein is the most commonly used conduit in patients undergoing coronary artery bypass surgery yet its patency is inferior to the internal thoracic artery. Vascular damage inflicted to the vein when using conventional harvesting techniques affects its structure. Endothelial denudation is associated with early vein graft failure while damage of the outermost vessel layers has adverse long-term effects on graft performance. ⋯ A 'no-touch' technique, where the saphenous vein is removed with minimal trauma and normal architecture preserved, produces a superior graft with long term patency comparable to the internal thoracic artery. Interestingly, many experimental studies are aimed at repairing or replacing those regions of the saphenous vein damaged when harvesting conventionally. 'No-touch' harvesting is superior in coronary artery bypass patients with long-term data published 5years ago. Here we describe a 'bedside to bench' situation where the mechanisms underlying the improved performance of 'no touch' saphenous vein grafts in patients have been studied in the laboratory.
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Rho proteins, best known for their regulatory role in actin dynamics, stimulate a variety of processes important in the control of vascular function, including morphogenesis, migration, cell proliferation and adhesion, cell survival, gene expression, vesicle transport and microparticle formation. Rho GTPases have been implicated in several pulmonary vascular pathologies. Here we give an overview of the current knowledge of the role of Rho GTPases in vascular dysfunction, and pulmonary diseases such as pulmonary hypertension, pulmonary embolism, chronic obstructive pulmonary disease, acute lung injury and acute respiratory distress syndrome.