HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Violaris, A. G. Articles by Angelini, G. D. Search for Related Content PubMed PubMed Citation Articles by Violaris, A. G. Articles by Angelini, G. D.

Ann Thorac Surg 1993;55:667-671
© 1993 The Society of Thoracic Surgeons

---

Articles

Effects of external stenting on wall thickening in arteriovenous bypass grafts

^a Cardiac Surgery Department, University of Sheffield, Sheffield, United Kingdom
^b Cardiology Department, University of Wales College of Medicine, Cardiff, United Kingdom

Accepted for publication June 18, 1992.

^_* Address reprint requests to Mr Angelini, Department of Cardiac Surgery, University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.

	Abstract

Top Abstract Footnotes References

 
Late occlusion of the saphenous vein graft appears to result in part from wall thickening as an adaptation to increased mean wall stress. Using an established pig model of arteriovenous bypass grafting, the effect of reducing wall stress with an external porous polytetrafluoroethylene stent was investigated. Segments of autologous saphenous vein were implanted by end-to-end anastomoses into both carotid arteries, with one graft supported by a stent 4 mm in diameter. Increases in graft wall dimensions were quantified 4 weeks later by computer-aided planimetry of transverse histological sections. The contribution of hyperplasia (i.e., cell proliferation) to the changes observed was further clarified by measurements of DNA concentration. All grafts showed an increase in external size, but this was restricted by stenting. All grafts also showed an increase in crosssectional area of the tunica media and tunica intima that was only partly accounted for by an increase in DNA concentration, which indicated that both hyperplasia and hypertrophy had occurred. Stented grafts showed less enlargement of the media but greater enlargement of the intima. Overall wall size was therefore similar in stented and unstented grafts. Stented grafts showed less increase in DNA concentration than unstented grafts. In stented grafts, the residual luminal cross-sectional area was significantly less than in unstented grafts. The data show that external stenting reduces medial enlargement and hyperplasia but increases encroachment of the intima into the lumen. Because final luminal size is thought to be of paramount importance in maintaining long-term patency, external stenting is unlikely to be of benefit.

	Footnotes

Top Abstract Footnotes References

 
Supported by grants from the British Heart Foundation and the National Heart Research Fund.

	References

Top Abstract Footnotes References

 

1. Angelini GD, Bryan AJ, West RR, Newby AC, Breckenridge IM. Coronary artery bypass surgery: current practice in the United Kingdom Thorax 1989;44:721-724.[Abstract/Free Full Text]
2. Lytle BW, Loop FD, Cosgrove DM, Ratliff NB, Easley K, Taylor PC. Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts J Thorac Cardiovasc Surg 1985;89:248-258.[Abstract]
3. Angelini GD, Newby AC. The future of saphenous vein as a coronary artery bypass conduit Eur Heart J 1989;10:273-280.[Abstract/Free Full Text]
4. Zwolak RM, Adams MC, Clowes AW. Kinetics of vein graft hyperplasia: association with tangential stress J Vasc Surg 1987;5:126-136.[Medline]
5. Boerboom LE, Bonchek LI, Kissebah AH, et al. Effect of surgical trauma on lipids in primate vein grafts: relation to plasma lipids Circulation 1980;62(Suppl 1):142-147.
6. Angelini GD, Bryan AJ, Williams HMJ, Morgan R, Newby AC. Distension promotes platelet and leukocyte adhesion and reduces short-term patency in pig arteriovenous bypass grafts J Thorac Cardiovasc Surg 1990;99:433-439.[Abstract]
7. Gottlob R. The preservation of venous endothelium by dissection without touching and by an atraumatic technique of vascular anastomosis Minerva Chir 1977;32:693-700.[Medline]
8. Angelini GD, Passani SL, Breckenridge IM, Newby AC. Nature and pressure dependence of damage induced by distension of human saphenous vein coronary artery bypass grafts Cardiovasc Res 1985;19:326-334.[Abstract/Free Full Text]
9. Angelini GD, Bryan AJ, William HM, et al. Timecourse of medial and intimal thickening in pig arteriovenous bypass grafts. Relationship to endothelial injury and cholesterol accumulation J Thorac Cardiovasc Surg 1992;103:1093-1103.[Abstract]
10. Campeau L, Enjalbert M, Lesperance J, Vaislic C, Grondin CM, Bourassa MG. Atherosclerosis and late closure of saphenous vein grafts: sequential angiographic studies 2 weeks, 1 year, 5 to 7 years and 10 to 12 years after surgery Circulation 1983;68(Suppl 2):1-7.
11. Morinaga K, Okadome K, Kuroki M, Miyazaki T, Muto Y, Inokuchi K. Effect of wall shear stress on intimal thickening of arterially transplanted autogenous veins in dogs J Vasc Surg 1985;2:430-433.[Medline]
12. Friedman MH, Hutchins GM, Bargeron CB, Deters OJ, Mark FF. Correlation between intimal thickness and fluid shear in human arteries Atherosclerosis 1981;39:425-436.[Medline]
13. Karayannalos PE, Hostetler JR, Bono MG, et al. Late failure in vein grafts: mediating factors in subendothelial fibromuscular hyperplasia Ann Surg 1978;187:183-188.[Medline]
14. Barras JA, Volant A, Leroy JP, et al. Constrictive perivenous mesh prosthesis for preservation of vein integrity. Experimental results and application for coronary bypass grafting J Thorac Cardiovasc Surg 1986;92:330-336.[Abstract]
15. Kohler TR, Kirkman TR, Clowes AW. The effect of rigid external support on vein graft adaptation to the arterial circulation J Vasc Surg 1989;9:277-285.[Medline]

This article has been cited by other articles:

				L. C.H. John Biomechanics of Coronary Artery and Bypass Graft Disease: Potential New Approaches Ann. Thorac. Surg., January 1, 2009; 87(1): 331 - 338. [Abstract] [Full Text] [PDF]

				P. Zilla, P. Human, M. Wolf, W. Lichtenberg, N. Rafiee, D. Bezuidenhout, N. Samodien, C. Schmidt, and T. Franz Constrictive external nitinol meshes inhibit vein graft intimal hyperplasia in nonhuman primates J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 717 - 725. [Abstract] [Full Text] [PDF]

				J. Y. Jeremy, R. Bulbulia, J. L. Johnson, P. Gadsdon, V. Vijayan, N. Shukla, F. C. T. Smith, and G. D. Angelini A bioabsorbable (polyglactin), nonrestrictive, external sheath inhibits porcine saphenous vein graft thickening J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1766 - 1772. [Abstract] [Full Text] [PDF]

				M. Krejca, J. Skarysz, P. Szmagala, D. Plewka, G. Nowaczyk, A. Plewka, and A. Bochenek A new outside stent - does it prevent vein graft intimal proliferation? Eur J Cardiothorac Surg, December 1, 2002; 22(6): 898 - 903. [Abstract] [Full Text] [PDF]

				G. D. Angelini, C. Lloyd, R. Bush, J. Johnson, and A. C. Newby An external, oversized, porous polyester stent reduces vein graft neointima formation, cholesterol concentration, and vascular cell adhesion molecule 1 expression in cholesterol-fed pigs J. Thorac. Cardiovasc. Surg., November 1, 2002; 124(5): 950 - 956. [Abstract] [Full Text] [PDF]

				J.H.P. Lardenoye, M.R. de Vries, J.M. Grimbergen, L.M. Havekes, M.W.M. Knaapen, M.M. Kockx, V.W.M. van Hinsbergh, J.H. van Bockel, and P.H.A. Quax Inhibition of Accelerated Atherosclerosis in Vein Grafts by Placement of External Stent in ApoE*3-Leiden Transgenic Mice Arterioscler Thromb Vasc Biol, September 1, 2002; 22(9): 1433 - 1438. [Abstract] [Full Text] [PDF]

				C Le Feuvre, G Dambrin, G Helft, F Beygui, M Touam, J P Grunfeld, A Vacheron, and J P Metzger Clinical outcome following coronary angioplasty in dialysis patients: a case-control study in the era of coronary stenting Heart, May 1, 2001; 85(5): 556 - 560. [Abstract] [Full Text]

				G. Stewart, A. G. Jardine, and J. D. Briggs Ischaemic heart disease following renal transplantation Nephrol. Dial. Transplant., February 1, 2000; 15(2): 269 - 277. [Full Text] [PDF]

				J. E. O'Brien Jr., Y. Shi, A. Fard, T. Bauer, A. Zalewski, and J. D. Mannion WOUND HEALING AROUND AND WITHIN SAPHENOUS VEIN BYPASS GRAFTS J. Thorac. Cardiovasc. Surg., July 1, 1997; 114(1): 38 - 45. [Abstract] [Full Text]

				R. Brauner, H. Laks, D. C. Drinkwater Jr., G. Chaudhuri, O. Shvarts, T. Drake, S. Bhuta, D. Mishaly, I. Fishbein, and G. Golomb CONTROLLED PERIADVENTITIAL ADMINISTRATION OF VERAPAMIL INHIBITS NEOINTIMAL SMOOTH MUSCLE CELL PROLIFERATION AND AMELIORATES VASOMOTOR ABNORMALITIES IN EXPERIMENTAL VEIN BYPASS GRAFTS J. Thorac. Cardiovasc. Surg., July 1, 1997; 114(1): 53 - 63. [Abstract] [Full Text]

				M. B. Izzat, D. Mehta, A. J. Bryan, B. Reeves, A. C. Newby, and G. D. Angelini Influence of External Stent Size on Early Medial and Neointimal Thickening in a Pig Model of Saphenous Vein Bypass Grafting Circulation, October 1, 1996; 94(7): 1741 - 1745. [Abstract] [Full Text]

				G. D. Angelini, M. B. Izzat, A. J. Bryan, and A. C. Newby EXTERNAL STENTING REDUCES EARLY MEDIAL AND NEOINTIMAL THICKENING IN A PIG MODEL OF ARTERIOVENOUS BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 79 - 84. [Abstract] [Full Text]

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Violaris, A. G. Articles by Angelini, G. D. Search for Related Content PubMed PubMed Citation Articles by Violaris, A. G. Articles by Angelini, G. D.