Document Detail


Increased blood flow inhibits neointimal hyperplasia in endothelialized vascular grafts.
MedLine Citation:
PMID:  1954675     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intimal hyperplasia is a primary cause of failure after vascular reconstruction and may be affected by blood flow. We have studied the effects of increased blood flow on intimal hyperplasia in porous polytetrafluoroethylene grafts implanted in baboons. These grafts develop an endothelial lining by 2 weeks and neointimal thickening due to proliferation of underlying smooth muscle cells by 1 month. Creation of a distal arteriovenous fistula increased flow (from 230 +/- 35 to 785 +/- 101 ml/min, p less than 0.001) and mean shear (from 26 +/- 4 to 78 +/- 10 dynes/cm2, p less than 0.001) without causing a drop in pressure across the grafts. Fistula flow did not alter the pattern of endothelial coverage but did cause a marked reduction in the cross-sectional area of the neointima (from 2.60 +/- 0.52 to 0.42 +/- 0.07 mm2 at 3 months, p less than 0.01). Detailed morphometric analysis revealed an equivalent percentage decrease in smooth muscle cells and matrix content, suggesting that the primary effect of increased flow was to reduce smooth muscle cell number without affecting the amount of matrix produced by individual cells. The neointima remained sensitive to changes in flow at late times; ligation of the fistula after 2 months resulted in a rapid increase in neointimal thickness (from 0.60 +/- 0.03 mm2 after 2 months of fistula flow to 3.88 +/- 0.55 mm2 1 month after ligation of fistula, p less than 0.01). These results support the hypothesis that changes in blood flow affect the structure of diseased as well as normal vessels.
Authors:
T R Kohler; T R Kirkman; L W Kraiss; B K Zierler; A W Clowes
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation research     Volume:  69     ISSN:  0009-7330     ISO Abbreviation:  Circ. Res.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-02     Completed Date:  1992-01-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1557-65     Citation Subset:  IM    
Affiliation:
Department of Veterans Affairs Medical Center, University of Washington, Seattle.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Flow Velocity*
Blood Vessel Prosthesis*
Endothelium, Vascular / pathology*
Hemodynamics
Hyperplasia
Male
Muscle, Smooth, Vascular / pathology*
Papio
Vascular Patency
Grant Support
ID/Acronym/Agency:
HL-30946/HL/NHLBI NIH HHS; RR00166/RR/NCRR NIH HHS

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


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