Document Detail

Influence of external stent size on early medial and neointimal thickening in a pig model of saphenous vein bypass grafting.
MedLine Citation:
PMID:  8840869     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Late saphenous vein graft failure results from intimal and medial thickening due to migration and proliferation of vascular smooth muscle cells and superimposed atheroma. These changes may represent an adaptation by the vein to its insertion into the arterial system. Using a porcine model of arteriovenous bypass grafting, we recently demonstrated that supporting the graft with a nonrestrictive external Dacron velour stent significantly reduced intimal hyperplasia and total wall thickness. In the present study, we investigated the influence of different external stent sizes on graft wall dimensions and cell proliferation. METHODS AND RESULTS: Three stent sizes were tested: mildly restrictive, nonrestrictive, and oversized (5, 6, and 8 mm in diameter, respectively). Four weeks after grafting, total wall thickness was decreased 40% by 5-mm stents (P = .02), 66% by 6-mm stents (P = .0004), and 81% by 8-mm stents (P = .02 versus unstented grafts). Neointimal thickness was reduced almost 62% by 6-mm and 72% by 8-mm stents (both P = .01) but not by 5-mm stents. As a result, the encroachment of the intima into the lumen was reduced approximately 70% by 6- or 8-mm stents (P = .02 and P = .01 versus unstented grafts, respectively). Both neointimal and medial cell proliferation were significantly reduced by all three stents compared with unstented grafts. CONCLUSIONS: External stenting of saphenous vein bypass grafts reduces early intimal and medial hyperplasia. Oversized stents give equally profound suppression of intimal thickening, obviating the need for precise size matching with the graft and greatly simplifying the surgical procedure.
M B Izzat; D Mehta; A J Bryan; B Reeves; 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:  Circulation     Volume:  94     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-29     Completed Date:  1996-11-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1741-5     Citation Subset:  AIM; IM    
Bristol Heart Institute, University of Bristol, UK.
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MeSH Terms
Carotid Arteries / surgery*
Cell Division
Cerebral Revascularization*
Equipment Design
Proliferating Cell Nuclear Antigen / metabolism
Saphenous Vein / metabolism,  pathology,  transplantation*
Tunica Intima / pathology*
Tunica Media / pathology*
Reg. No./Substance:
0/Proliferating Cell Nuclear Antigen

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

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