Arterial grafts radial

Small-diameter arterial grafts using biotextiles 431 Radial strain, therefore, can be expressed thus ... 

FIGURE 45-1. The predominant types of vascular access for chronic dialysis patients are (A) the arteriovenous fistula and (B) the synthetic arteriovenous forearm graft. The first primary arteriovenous fistula is usually created by the surgical anastomosis of the cephalic vein with the radial artery. The flow of blood from the higher-pressure arterial system results in hypertrophy of the vein. The most common AV graft is between the brachial artery and the basilic or... 

Reversed segments of autologous saphenous vein can be used as appropriate conduits. Particularly in coronary revascularization, the internal mammary arteries and the radial arteries have widely been used [3]. However, autologous vessels may be insufficient for multiple or repeated bypasses and/or saphenous veins may have varicose degenerative alterations. Therefore, allograft arteries and veins as well as synthetic tubes have been developed, but they proved to be less satisfactory as conduits [4, 5] particularly, synthetic grafts with an internal diameter of 6 mm or less are prone to thrombus induction and occlusion [6]. 

Cameron J, Trivedi S, Stafford G, et al. Five-year angiographic patency of radial artery bypass grafts. Circulation 2004 110(Suppl. II) II23-6. 

Desai ND, Cohen EA, Naylor CD, et al. A randomized comparison of radial-artery and saphenous vein coronary bypass grafts. NEngl J Med 2004 351 2302-9. 

The patency of the grafts is also dependent on their abilities to withstand the high pulsatile stresses, which range from 80 to i20 mmHg in arteries and result in radial distensions up to 10%. The robust mechanical properties of the graft are imparted primarily by the tunica media and rely on the aUgn-ment of the smooth muscle cells (SMCs) and their maintenance of a contractile phenotype. The spatial... 

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