Skip to main content
Log in

Theoretical study of the effect of local flow disturbances on the concentration of low-density lipoproteins at the luminal surface of end-to-end anastomosed vessels

  • Published:
Medical and Biological Engineering and Computing Aims and scope Submit manuscript

Abstract

To elucidate the mechanisms of localisation of intimal hyperplasia in anastomosed arteries, the effects of flow disturbances on the transport of lowdensity lipoproteins (LDLs) from the flowing blood to the wall of end-to-end anastomosed arteries, with and without a moderate stenosis, were studied theoretically by means of a computer simulation under the condition of steady flow. In an artery with moderate stenosis at the anastomotic junction and intimal thickening distal to it, we found that, owing to the water-permeable nature of the arterial wall, the surface concentration of LDL was elevated up to 20% higher than that of the bulk flow distal to the stenosis, where a recirculation zone was formed and wall shear stresses were low. In contrast to this, no significant elevation of surface concentration of LDLs occurred in another anastomosed vessel in which no stenosis was formed and no intimal thickening was observed. These results suggest that flowdependent concentration polarisation of LDLs plays a causative role in the localisation of anastomotic intimal hyperplasia in the human arterial system by locally elevating the surface concentration of LDLs, thus augmenting their uptake by endothelial cells.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Asakura, T., andKarino, T. (1990): ‘Flow patterns and spatial distribution of atherosclerotic lesions in human coronary arteries’,Circ. Res.,66, pp. 1045–1066

    Google Scholar 

  • Bassiouny, H.S., White, S., Glagov, S., Choi, E., Giddens, D. P., andZarins, C. K. (1992): ‘Anastomotic intimal hyperplasia: mechanical injury or flow induced’,J. Vasc. Surg.,15, pp. 708–717

    Google Scholar 

  • Baumann, D. S., Doblas, M., Daugherty, A., Sicard, G., andSchonfeld, G. (1994): ‘The role of cholesterol accumulation in prosthetic vascular graft anastomotic intimal hyperplasia’,J. Vasc. Surg.,19, pp. 435–445

    Google Scholar 

  • Bratzler, B. L., Chisolm, G. M., Colton, C. K., Smith, K.A., andLees, R. S. (1977): ‘The distribution of labeled low-density lipoproteins across the rabbit thoracicin vivo’,Atherosclerosis,28, pp. 289–307

    Article  Google Scholar 

  • Brooks, A. N., andHughes, T. J. R. (1982): ‘Streamline upwind/Petrov-Galerkin formulations for convection dominated flow with particular emphasis on the incompressible Navier-Stokes equations’,Comput. Methods Appl. Mech. Eng.,32, pp. 199–259

    Article  MathSciNet  Google Scholar 

  • Campeau, L. (2000): ‘Lipid lowering and coronary bypass graft surgery’,Curr. Opin. Cardiol.,15, pp. 395–399

    Google Scholar 

  • Chuang, P. T., Cheng, H. J., Lin, S. J., Jan, K. M., Lee, M. M., andChien, S. (1990): ‘Macromolecular transport across arterial and venous endothelium in rats. Studies with Evans blue-albumin and horseradish peroxidase’,Arteriosclerosis,10, pp. 188–197

    Google Scholar 

  • Clowes, A. W., Gown, A. M., Hanson, S. R., andReidy, M. A. (1985): ‘Mechanisms of arterial graft failure. 1. Role of cellular proliferation in early healing of PTFE prostheses’,Am. J. Pathol.,118, pp. 43–54

    Google Scholar 

  • Deng, X., Marois, Y., How, T., Merhi, Y., King, M., Guidoin, R., andKarino, T. (1995): ‘Luminal surface concentration of lipoprotein (LDL) and its effect on the wall uptake of cholesterol by canine carotid arteries’,J. Vasc. Surg.,21, pp. 135–145, and22, pp. 9A and 648

    Article  Google Scholar 

  • Friedman, M. H., Henderson, J. M., Aukerman, J. A., andClingan, P. A. (2000): ‘Effect of periodic alterations in shear on vascular macromolecular uptake’,Biorheology,37, pp. 265–277

    Google Scholar 

  • Fry, D. L. (1977): ‘Aortic Evans blue dye accumulation: its measurement and interpretation’,Am. J. Physiol.,232, (Heart Circ. Physiol.,1) pp. H204-H222

    Google Scholar 

  • Gudoin, R., Couture, J., Assayed, F., andGosselin, C. (1988): ‘New frontiers of vascular grafting’,Int. Surg.,73, pp. 241–249

    Google Scholar 

  • Hoff, H. F., andWagner, W. D. (1986): ‘Plasma low density lipoprotein accumulation in aortas of hypercholesterolemic swine correlates with modifications in aortic glycosaminoglycan composition’,Atherosclerosis,61, pp. 231–236

    Article  Google Scholar 

  • Hunninghake, D. B. (1998): ‘Is aggressive cholesterol control justified? Review of the post-coronary artery bypass graft trial’,Am. J. Cardiol.,82, pp. 45T-48T

    Article  Google Scholar 

  • Imparato, A. M., Bracco, A., Kim, G. E., andZeff, R. (1972): ‘Intimal and neointimal fibrous proliferation causing failure of arterial reconstructions’,Surgery,72, pp. 1007–1017

    Google Scholar 

  • Ishibashi, H., Sunamura, M., andKarino, T. (1995): ‘Flow patterns and preferred sites of intimal thickening in end-to-end anastomosed vessels’,Surgery,117, pp. 409–420

    Google Scholar 

  • Jo, H., Dull, R. O., Hollis, T. M., andTarbell, J. M. (1991): ‘Endothelial albumin permeability is shear dependent, time dependent, and reversible’,Am. J. Physiol.,260, pp. H1992-H1996

    Google Scholar 

  • Karino, T., andMotomiya, M. (1983): ‘Flow visualization in isolated transparent natural blood vessel’,Biorheology,20, pp. 119–127

    Google Scholar 

  • Kleinstreuer, C., Hyun, S., Buchanan, J. R. Jr., Longest, P. W., Archie, J. P. Jr., andTruskey, G. A. (2001): ‘Hemodynamic parameters and early intimal thickening in branching blood vessels’,Crit. Rev. Biomed. Eng.,29, pp. 1–64

    Google Scholar 

  • Klyachkin, M. L., Davies, M. G., Svendsen, E., Kim, J. H., Massey, M. F., Barber, L., McCann, R. L., andHagen, P. O. (1993): ‘Hypercholesterolemia and experimental vein grafts: accelarated development of intimal hyperplasia and an increase in abnormal vasomotor function’,J. Surg. Res.,54, pp. 451–468

    Article  Google Scholar 

  • Ku, D. N., Giddens, D. P., Zarins, C. K., andGlagov, S. (1985): ‘Pulsatile flow and atherosclerosis in the human carotid bifurcation: positive correlation between plaque location and low oscillating shear stress’,Arteriosclerosis,5, pp. 293–302

    Google Scholar 

  • Mii, S., Okadome, K., Onohara, T., Yamamura, S., andSugimachi, K. (1990): ‘Intimal thickening and permeability of arterial autogenous vein graft in a canine poor-runoff model: transmission electron microscopic evidence’,Surgery,108, pp. 81–89

    Google Scholar 

  • Miller, J. H., Foreman, R. K., Ferguson, L., andFaris, I. (1984): ‘Interposition vein cuff for anastomosis of prosthesis to small artery’,Aust. N. Z. J. Surg.,54, pp. 283–285

    Google Scholar 

  • Naiki, T., Sugiyama, H., Tashiro, R. andKarino, T. (1999): ‘Flowdependent concentration polarization of plasma proteins at the luminal surface of a cultured endothelial cell monolayer’,Biorheology,36, pp. 225–241

    Google Scholar 

  • Pedersen, E. M., Qyre, S., Agerbaek, M., Kristensen, I. B., Ringgaard, S., Boesiger, P., and Paaske, W. P. (1999): ‘Distribution of early atherosclerotic lesions in the human abdominal aorta correlates with wall shear stresses measured in vivo’,Eur. J. Vasc. Endovasc. Surg.,18, pp. 328–333

    Article  Google Scholar 

  • Ross, R., andHarker, L. (1976): ‘Hyperlipidemia and atherosclerosis: chronic hyperlipidemia initiates and maintains lesions by endothelial cell desquamation and lipid accumulation’,Science,193, pp. 1094–1100

    Google Scholar 

  • Sottiurai, V. S., Yao, J. S., Batson, R. C., Sue, S. L., Jones, R., andNakamura, Y. A. (1989): ‘Distal anastomotic intimal hyperplasia: histopathologic character and biogenesis’,Ann. Vasc. Surg.,3, pp. 26–33

    Google Scholar 

  • Stary, H. C., Chandler, A. B., Glagov, S., Guyton, J. R., Insull, W., Jr., Rosenfeld, M. E., Schaffer, A., Schwarit, C. J., Wagner, W. D., andWissler, R. W. (1994): ‘A definition of initial, fatty streak, and intermediate lesions of atherosclerosis: a report from the committee on vascular lesions of the council on arteriosclerosis’,Arterioscler. Thromb.,14, pp. 840–856

    Google Scholar 

  • Taylor, R. S., Loh, A., McFarland, R. J., Cox, M., andChester, J. F. (1992): ‘Improved technique for polytetrafluoroethylene bypass grafting: long-term results using anastomotic vein patches’,Br. J. Surg.,79, pp. 348–354

    Google Scholar 

  • Tedgui, A., andLever, M. J. (1984): ‘Filtration through damaged and undamaged rabbit thoracic aorta’,Am. J. Physiol.,247, (Heart Circ. Physiol.,16), pp. H784-H791

    Google Scholar 

  • Truskey, G. A., Roberts, W. L., Herrmann, R. A., andMalinauskas, R. A. (1992): ‘Measurement of endothelial permeability to125I-low density lipoproteins in rabbit arteries by use ofen face preparations’,Circ. Res.,71, pp. 883–897

    Google Scholar 

  • Tyrrell, M. R., andWolfe, J. H. (1991): ‘New prosthetic venous collar anastomotic technique: combining the best of other procedures’,Br. J. Surg.,78, pp. 1016–1017

    Google Scholar 

  • Vasile, K., Simionescu, M., andSimionescu, N. (1983): ‘Visualization of the binding, endocytosis, and transcytosis of low-density lipoprotein in the arterial endotheliumin situ’,J. Cell. Biol.,96, pp. 1677–1689

    Article  Google Scholar 

  • Wada, S., andKarino, T. (1999): ‘Theoretical study on flowdependent concentration polarization of low density lipoproteins at the luminal surface of a straight artery’,Biorheology,36, pp. 207–223

    Google Scholar 

  • Wada, S., andKarino, T. (2002a): ‘Theoretical prediction of LDL concentration at the luminal surface of an artery with a multiple bend’,Ann. Biomed. Eng.,30, pp. 778–791

    Article  Google Scholar 

  • Wada, S., andKarino, T. (2002b) ‘Prediction of LDL concentration at the luminal surface of a vascular endothelium’,Biorheology,39, pp. 331–336

    Google Scholar 

  • Wada, S., Kaichi, M., andKarino, T. (2001a): ‘Changes in water filtration velocity and wall structure of the rabbit common carotid artery after removal of the adventitia’,JSME Int. J., C44, pp. 996–1004

    Google Scholar 

  • Wada, S., Koujiya, M., andKarino, T. (2001b): ‘The effect of creating a moderate stenosis on the localization of intimal thickening in the common carotid artery of the rabbit fed on a cholesterol-rich diet’,JSME Int. J. C44, pp. 1021–1030

    Google Scholar 

  • Weinbaum, S., Tzeghai, G., Ganatos, P., Pfeffer, R., andChien, S. (1985): ‘Effect of cell turnover and leaky junctions on arterial macromolecular transport’,Am. J. Physiol.,248, pp. H945-H960

    Google Scholar 

  • Zarins, C. K., Giddens, D. P., Bharadvaj, B. K., Sottiurai, V. S., Mabon, R. F., andGlagov, S. (1983): ‘Carotid bifurcation atherosclerosis: quantitative correlation of plaque localization with flow velocity profiles and wall shear stress’,Circ. Res.,53, pp. 502–514

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Wada.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wada, S., Koujiya, M. & Karino, T. Theoretical study of the effect of local flow disturbances on the concentration of low-density lipoproteins at the luminal surface of end-to-end anastomosed vessels. Med. Biol. Eng. Comput. 40, 576–587 (2002). https://doi.org/10.1007/BF02345458

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02345458

Key words

Navigation