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ISRN Vascular Medicine
Volume 2012 (2012), Article ID 710765, 23 pages
http://dx.doi.org/10.5402/2012/710765
Review Article

Targeted Treatments for Restenosis and Vein Graft Disease

Bristol Heart Institute, University of Bristol, 7th Floor, Queens Building, Bristol Royal Infirmary, Bristol BS2 8HW, UK

Received 30 September 2012; Accepted 4 November 2012

Academic Editors: C. Hermenegildo, A. Paolicchi, and B. Tesfamariam

Copyright © 2012 Anita C. Thomas. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Surgery to restore blood flow in arteries blocked by atherosclerotic plaque is a common treatment in cardiovascular disease. Long-term complications of surgical treatment are vein graft disease and restenosis, a renarrowing of the blood vessel after bypass or removal of the culprit atherosclerotic plaque. Attempts to prevent or treat these complications by systemic pharmacological approaches have been largely unsuccessful in the clinic. This has led to an interest in developing targeted or locally delivered strategies. This paper discusses many of the various site-delivered therapies that are under examination as potential antirestenotic and antivein graft disease agents (including antithrombotic, antiproliferative, and anti-inflammatory agents) and why many therapies developed in animal models fail in clinical trials. Techniques of targeted delivery (including stents, “magic bullets,” and adventitial delivery) and delivery systems (including nanoparticles and the use of gene therapy) are also discussed.