Prevention of Autologous Vein Graft Atherosclerosis Thru Cell Cycle Inhibition.
- Author:
Doo Sang KIM
1
;
Sung Hyuk PARK
;
Ji Won JANG
;
Yong Soon WON
;
Hyuk AHN
;
Wook YOUM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul Veterans Hospital, Korea. doosang1@dreamx.net
- Publication Type:Original Article
- Keywords:
Autologous;
Vein;
Graft;
Atherosclerosis;
Neointima;
Hyperplasia
- MeSH:
Animals;
Atherosclerosis*;
Carotid Arteries;
Cell Cycle*;
DNA;
Dogs;
Hyperplasia;
Jugular Veins;
Lower Extremity;
Models, Theoretical;
Neointima;
Phenobarbital;
Reoperation;
Transplants*;
Veins*
- From:Journal of the Korean Society for Vascular Surgery
2002;18(2):243-250
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Autologous vein graft is the most commonly used conduit for surgical revascularization of the small and medium sized vessels of the coronary and lower extremity circulations. But, 30~50% of these grafts succumb eventually to occlusive failure, often with recurrent morbidity that necessitates reoperation. The cause of failure is the vein graft atherosclerosis from the neointimal hyperplasia, which is the arterial remodeling process through adaptive thickening of the vein wall in response to the increased wall stress. We try to use cis-platin, DNA binding cell cycle specific inhibitory agent, against neointimal hyperplasia in experimental model. METHOD: 5 korean dogs had a autologous vein graft interposition at femoral or carotid arteries using saphenous or jugular veins bilaterally. One side of pairs is treated with cis-platin for one hour (study), while the other is not (conrol). After 4 weeks, we explanted 6 pairs of vein graft (3 jugular veins and 3 saphenous veins), and measured intimal thickness, intimal area and luminal area using videomorphometry, and analysed intimal ratio and luminal ratio. RESULT: Treatment with cis-platin reduced intimal thickness by 44% (P=0.0118) and intimal area by 50% (P=0.0124). Intimal ratio was decreased in the study group when compared to the control group by 0.18 versus 0.66 (P=0.001). The luminal area of the treated grafts was significantly larger than controls, having increased by 823% (P=0.0307), and luminal ratio having increased by 0.82 versus 0.34 (P=0.001). CONCLUSION: These results suggest that cis-platin reduced the development of neointimal hyperplasia in experimental vein grafts. In order to prove the obtained results to a higher degree, an accumulation of further cases is necessary.
