| Anastomotic intimal hyperplasia: mechanical injury or flow induced. | |
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MedLine Citation:
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PMID: 1560562 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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All anastomotic intimal thickening may not be the same, and the underlying mechanism(s) regulating the different types may vary. We investigated the localization of experimental anastomotic intimal thickening in relation to known biomechanical and hemodynamic factors. Bilateral iliofemoral saphenous vein and polytetrafluoroethylene grafts were implanted in 13 mongrel dogs. The distal end-to-side anastomotic geometry was standardized, and the flow parameters were measured. After 8 weeks, seven of 10 animals (group I) with patent grafts were killed and the anastomoses fixed by perfusion. Histologic sections from each anastomosis were studied with light microscopy, and regions of intimal thickening were identified and quantitated with use of oculomicrometry. To characterize the anastomotic flow patterns, transparent silicone models were constructed from castings of the distal anastomosis of three animals (group II), and flow was visualized with use of helium-neon laser-illuminated particles under conditions simulating the in vivo pulsatile flow parameters. Histologic sections revealed two separate and distinct regions of anastomotic intimal thickening. The first, suture line intimal thickening, was greater in polytetrafluoroethylene anastomoses (0.35 +/- 0.23 microns) than in vein anastomoses (0.15 +/- 0.03 microns, p less than 0.05). The second distinct type of intimal thickening developed on the arterial floor and was the same in polytetrafluoroethylene (0.11 +/- 0.11 microns) and vein anastomoses (0.12 +/- 0.03 microns). Model flow visualization studies revealed a flow stagnation point along the arterial floor resulting in a region of low and oscillating shear where the second type of intimal thickening developed. High shear and short particle residence time were observed along the hood of the graft, an area devoid of intimal thickening.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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H S Bassiouny; S White; S Glagov; E Choi; D P Giddens; C K Zarins |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter Volume: 15 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 1992 Apr |
Date Detail:
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Created Date: 1992-05-14 Completed Date: 1992-05-14 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 708-16; discussion 716-7 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Chicago, IL 60637. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical
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adverse effects Animals Blood Vessel Prosthesis / adverse effects* Dogs Hyperplasia / etiology Iliac Artery / injuries, pathology*, surgery* Male Polytetrafluoroethylene Pulsatile Flow Saphenous Vein / pathology*, transplantation |
| Grant Support | |
ID/Acronym/Agency:
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5 ROI-HL41267/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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9002-84-0/Polytetrafluoroethylene |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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