| Increased blood flow inhibits neointimal hyperplasia in endothelialized vascular grafts. | |
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MedLine Citation:
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PMID: 1954675 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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T R Kohler; T R Kirkman; L W Kraiss; B K Zierler; A W Clowes |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation research Volume: 69 ISSN: 0009-7330 ISO Abbreviation: Circ. Res. Publication Date: 1991 Dec |
Date Detail:
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Created Date: 1992-01-02 Completed Date: 1992-01-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0047103 Medline TA: Circ Res Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1557-65 Citation Subset: IM |
Affiliation:
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Department of Veterans Affairs Medical Center, University of Washington, Seattle. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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