Document Detail


Effects of external stenting on wall thickening in arteriovenous bypass grafts.
MedLine Citation:
PMID:  8452428     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 cross-sectional 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.
Authors:
A G Violaris; A C Newby; G D Angelini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  55     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-15     Completed Date:  1993-04-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  667-71     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Surgery Department, University of Sheffield, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Animals
Carotid Artery, Common / surgery*
DNA / biosynthesis
Saphenous Vein / metabolism,  pathology*,  transplantation*
Stents*
Swine
Tunica Intima / metabolism,  pathology
Tunica Media / metabolism,  pathology
Vascular Patency
Chemical
Reg. No./Substance:
9007-49-2/DNA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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