Skip to main content
SpringerLink
Log in

Short-term effects of double-layer autologous vein graft on restraint of excessive distension and alleviation of neointimal hyperplasia in a porcine saphenous vein graft model

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Although the use of external vein graft support seems a promising approach to prevent neointimal hyperplasia and wall thickening in vein grafts, its extensive clinical application still has a long way to go. The aim of this study was to evaluate short-term effects of self-designed double-layer autologous saphenous vein graft on restraining excessive distension of vein graft and alleviating neointimal hyperplasia in a porcine model. Left and right hind femoral arteries of 24 white pigs were randomly divided into an experimental group (double-layer vein graft) and a control group (single-layer vein graft). After 1 h of implantation, then 1, 2, and 4 weeks later, the mean inner diameter of the vein grafts in the experimental group measured by Doppler-ultrasound was 2.7 ± 0.1, 2.8 ± 0.1, 2.9 ± 0.1, and 3.1 ± 0.1 mm, respectively; mean peak blood flow velocity measured by Doppler-ultrasound was 96.7 ± 12.8, 93.7 ± 11.5, 89.4 ± 9.6 and 84.6 ± 10.1 cm/s, respectively, while the mean neointimal thicknesses were 47.1 ± 7.7, 93.7 ± 15.1, and 177.4 ± 25.5 μm at 1, 2 and 4 weeks, respectively. As compared to the control group, inner diameter and neointimal thickness of vein grafts in the experimental group were significantly lower, while mean peak blood flow velocity was significantly higher at 1, 2, and 4 weeks after implantation. The proliferation index in the experimental group was also significantly lower within 4 weeks after implantation. The self-designed double-layer autologous saphenous vein graft restrains early excessive distension of vein graft and alleviates early neointimal hyperplasia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Santarpino G, Onorati F, Scalas C, De Gori M, Cristodoro L, Zofrea S, Renzulli A (2009) Radial artery achieves better flowmetric results than saphenous vein in the elderly. Heart Vessels 24:108–115

    Article  PubMed  Google Scholar 

  2. Onorati F, Santarpino G, Lerose MA, Impiombato B, Mastroroberto P, Renzulli A (2008) Intraoperative behavior of arterial grafts in the elderly and the young: a flowmetric systematic analysis. Heart Vessels 23:316–324

    Article  PubMed  Google Scholar 

  3. Batellier J, Wassef M, Merval R, Duriez M, Tedgui A (1993) Protection from atherosclerosis in vein grafts by a rigid external support. Arterioscler Thromb 13:379–384

    PubMed  CAS  Google Scholar 

  4. Zwolak RM, Adams MC, Clowes AW (1987) Kinetics of vein graft hyperplasia: association with tangential stress. J Vasc Surg 5:126–136

    Article  PubMed  CAS  Google Scholar 

  5. Fitzgibbon GM, Kafka HP, Leach AJ, Keon WJ, Hooper GD, Burton JR (1996) Coronary bypass graft fate and patient outcome: angiographic follow-up of 5065 grafts related to survival and reoperation in 1388 patients during 25 years. J Am Coll Cardiol 28:616–626

    Article  PubMed  CAS  Google Scholar 

  6. Campeau L, Enjalbert M, Lesperance J, Bourassa MG, Kwiterovich P Jr, Wacholder S, Sniderman A (1984) The relation of risk factors to the development of atherosclerosis in saphenous-vein bypass grafts and the progression of disease in the native circulation. A study 10 years after aortocoronary bypass surgery. N Engl J Med 311:1329–1332

    Article  PubMed  CAS  Google Scholar 

  7. Angelini GD, Lloyd C, Bush R, Johnson J, Newby AC (2002) An external, oversized, porous polyester stent reduces vein graft neointima formation, cholesterol concentration, and vascular cell adhesion molecule 1 expression in cholesterol-fed pigs. J Thorac Cardiovasc Surg 124:950–956

    Article  PubMed  Google Scholar 

  8. Izzat MB, Mehta D, Bryan AJ, Reeves B, Newby AC, Angelini GD (1996) Influence of external stent size on early medial and neointimal thickening in a pig model of saphenous vein bypass grafting. Circulation 94:1741–1745

    PubMed  CAS  Google Scholar 

  9. Mehta D, George SJ, Jeremy JY, Izzat MB, Southgate KM, Bryan AJ, Newby AC, Angelini GD (1998) External stenting reduces long-term medial and neointimal thickening and platelet derived growth factor expression in a pig model of arteriovenous bypass grafting. Nat Med 4:235–239

    Article  PubMed  CAS  Google Scholar 

  10. Klesius AA, Konerding MA, Knez P, Dzemali O, Schmitz-Rixen T, Ackermann H, Moritz A, Kleine P (2007) External stenting with a new polyester mesh reduces neointimal hyperplasia of vein grafts in a sheep model. Int J Artif Organs 30:930–938

    PubMed  CAS  Google Scholar 

  11. Zurbrügg HR, Knollmann F, Musci M, Wied M, Bauer M, Chavez T, Krukenberg A, Hetzer R (2000) The biocompound method in coronary artery bypass operations: surgical technique and 3-year patency. Ann Thorac Surg 70:1536–1540

    Article  PubMed  Google Scholar 

  12. Moritz A, Raderer F, Magometschnigg H, Trubel W, Ullrich R, Laufer G, Staudacher M (1992) The use of mesh-tube-constricted dilated or varicose veins as arterial bypass conduit. Thorac Cardiovasc Surg 40:356–360

    Article  PubMed  CAS  Google Scholar 

  13. Jeremy JY, Bulbulia R, Johnson JL, Gadsdon P, Vijayan V, Shukla N, Smith FC, Angelini GD (2004) A bioabsorbable (polyglactin), nonrestrictive, external sheath inhibits porcine saphenous vein graft thickening. J Thorac Cardiovasc Surg 127:1766–1772

    Article  PubMed  Google Scholar 

  14. Vijayan V, Shukla N, Johnson JL, Gadsdon P, Angelini GD, Smith FC, Baird R, Jeremy JY (2004) Long-term reduction of medial and intimal thickening in porcine saphenous vein grafts with a polyglactin biodegradable external sheath. J Vasc Surg 40:1011–1019

    Article  PubMed  Google Scholar 

  15. Stooker W, Gök M, Sipkema P, Niessen HW, Baidoshvili A, Westerhof N, Jansen EK, Wildevuur CR, Eijsman L (2003) Pressure-diameter relationship in the human greater saphenous vein. Ann Thorac Surg 76:1533–1538

    Article  PubMed  Google Scholar 

  16. Kohler TR, Kirkman TR, Kraiss LW, Zieler BK, Clowes AW (1991) Increased blood flow inhibits neointimal hyperplasia in endothelialized vascular graft. Circ Res 69:1557–1565

    PubMed  CAS  Google Scholar 

  17. Dobrin PB, Littooy FN, Endean ED (1989) Mechanical factors predisposing to intimal hyperplasia and medial thickening in autogenous vein grafts. Surgery 105:393–400

    PubMed  CAS  Google Scholar 

  18. Dobrin PB (1995) Mechanical factors associated with the development of intimal and medial thickening in vein grafts subjected to arterial pressure. A model of arteries exposed to hypertension. Hypertension 26:38–43

    PubMed  CAS  Google Scholar 

Download references

Acknowledgment

Grant for the study is provided by second-stage project of Tongji University “985 ENGINEERING”.

Author information

Authors and Affiliations

  1. Department of Thoracic Cardiovascular Surgery of Tongji Hospital, Tongji University, 389 Xincun Rd., 200065, Shanghai, People’s Republic of China

    Qiang Ji, Yunqing Mei, Xisheng Wang, Jing Feng, Jianzhi Cai & Yifeng Sun

  2. Medical College of Tongji University, 1239 Siping Rd., 200092, Shanghai, People’s Republic of China

    Wusha Dewei, Chunping Wang & Liangjie Chi

Authors
  1. Qiang Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yunqing Mei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xisheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jing Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jianzhi Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yifeng Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wusha Dewei
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chunping Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Liangjie Chi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yunqing Mei.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ji, Q., Mei, Y., Wang, X. et al. Short-term effects of double-layer autologous vein graft on restraint of excessive distension and alleviation of neointimal hyperplasia in a porcine saphenous vein graft model. Heart Vessels 26, 190–195 (2011). https://doi.org/10.1007/s00380-010-0034-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-010-0034-z

Keywords

Search

Navigation