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Time-Dependent thickening of the intima in aortocoronary saphenous vein grafts: Clinicopathological analysis of 24 patients

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Summary

The present study was undertaken to investigate histological changes in aortocoronary saphenous vein grafts (SVGs) and the relationship between intimal thickening of the SVGs and the interval after grafting. The SVGs were divided into five groups according to the degree of intimal thickening and associated luminal narrowing: minimal thickening (0%–10% stenosis), slight thickening (11%–25% stenosis), slight-to-moderate thickening (26%–50% stenosis), moderate thickening (51%–75% stenosis), and severe thickening (76%–100% stenosis). SVGs showing minimal thickening had been implanted for 0–3 weeks, those with slight thickening for 2–13 weeks, those with slight-to-moderate thickening for 5–13 weeks, those with moderate thickening for 30–52 weeks, and those with severe thickening for 30–83 weeks. Thickening of the intima in SVGs (intimal hyperplasia) was time-dependent, and began as early as 2 weeks after the graft surgery. The change was diffuse and concentric, and observed from an aortic root to a coronary site. The major cell type involved in the intimal hyperplasia was the smooth muscle cell.

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References

  1. 1.

    Vlodaver Z, Edwards JE (1971) Pathologic changes in aortic-coronary arterial saphenous vein grafts. Circulation 44:719–728

  2. 2.

    Kern WH, Dermer GB, Lindesmith GG (1972) The intimal proliferation in aortic-coronary saphenous vein grafts. Light and electron microscopic studies. Am Heart J 84:771–777

  3. 3.

    Kern WH, Wells WJ, Meyer BW (1981) The pathology of surgically excised aortocoronary saphenous vein bypass grafts. Am J Surg Pathol 5:491–496

  4. 4.

    Smith SH, Geer JC (1983) Morphology of saphenous vein-coronary artery bypass grafts. Seven to 116 months after surgery. Arch Pathol Lab Med 107:13–18

  5. 5.

    Kalan JM, Roberts WC (1990) Morphologic findings in saphenous veins used as coronary arterial bypass conduits for longer than 1 year. Necropsy analysis of 53 patients, 123 saphenous veins, and 1865 5-mm segments of veins. Am Heart J 119:1164–1184

  6. 6.

    van der Wal AC, Becker AE, Elbers JRJ, Das PK (1992) An immunocytochemical analysis of rapidly progressive atherosclerosis in human vein grafts. Eur J Cardiothorac Surg 6:469–474

  7. 7.

    Bulkley BH, Mutchins GM (1977) Accelerated “atherosclerosis.” A morphologic study of 97 saphenous vein coronary artery bypass grafts. Circulation 55:163–169

  8. 8.

    Walts AE, Fishbein MC, Sustaita H, Matloff JM (1982) Ruptured atheromatous plaques in saphenous vein coronary artery bypass grafts. A mechanism of acute, thrombotic, late graft occlusion. Circulation 65:197–201

  9. 9.

    Ratliff NB, Myles JL (1989) Rapidly progressive atherosclerosis in aortocoronary saphenous vein grafts. Possible immune-mediated disease. Arch Pathol Lab Med 113:772–776

  10. 10.

    Ip JH, Fuster V, Badimon L, Badimon J, Taubman MB, Chesebro JH (1990) Syndromes of accelerated atherosclerosis. Role of vascular injury and smooth muscle cell proliferation. J Am Coll Cardiol 15:1667–1687

  11. 11.

    Kishikawa H, Shimokama T, Watanabe T (1993) Localization of T lymphocytes and macrophages expressing IL-1, IL-2 receptor, IL-6 and TNF in human aortic intima. Role of cell-mediated immunity in human atherogenesis. Virchows Arch [A] 423:433–442

  12. 12.

    Amano J, Suzuki A, Sunamori M, Tsukada T, Numano F (1991) Cytokinetic study of aortocoronary bypass vein grafts in place for less than 6 months. Am J Cardiol 67:1234–1236

  13. 13.

    Kocher O, Skalli O, Bloom WS, Gabbiani G (1984) Cytoskeleton of rat aortic smooth muscle cells. Normal conditions and experimental intimal thickening. Lab Invest 50:645–652

  14. 14.

    Ueda M, Becker AE, Tsukada T, Numano F, Fujimoto T (1991) Fibrocellular tissue response after percutaneous transluminal coronary angioplasty. An immunocytochemical analysis of the cellular composition. Circulation 83:1327–1332

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Author information

Correspondence to Takahiro Yamada.

Additional information

This work was supported, in part, by Grants-in-Aid for Scientific Research A (1993, no. 05770125) and (1994, no. 06770130) from the Ministry of Education, Science, and Culture of Japan.

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Yamada, T., Itoh, T., Nakano, S. et al. Time-Dependent thickening of the intima in aortocoronary saphenous vein grafts: Clinicopathological analysis of 24 patients. Heart Vessels 10, 41–45 (1995). https://doi.org/10.1007/BF01745076

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Key words

  • Saphenous vein grafts
  • Intimal hyperplasia
  • Atherosclerosis
  • Smooth muscle cells