Abstract:
BACKGROUND:Postmenopausal women taking hormone replacement therapy (HRT) require secondary intervention after vascular reconstruction more frequently than women not taking HRT, often due to increased development of intimal hyperplasia (IH). Matrix metalloproteinases (MMPs) play a role in IH by degradation and remodeling of components of the vascular basement membrane. The MMP pathway is regulated by a balance between MMPs, membrane-type MMPs (MT-MMPs), and tissue inhibitor of MMPs (TIMPs). We have recently provided evidence for unbalanced regulation of the MT1-MMP/MMP-2 pathway in vascular smooth muscle cells (VSMCs) exposed to hormones in vitro. Herein we study the role of HRT in the development of IH in a postmenopausal rodent model of vascular injury and in the modulation of this MMP regulatory pathway in vivo. METHODS:Female rats were aged to 12 months. Animals were ovariectomized (OVX) and 4 weeks later hormones or placebo was delivered via a 90-day slow-release pellet. After 6 weeks of HRT each rat underwent balloon angioplasty of the left common carotid artery. At 14 days postinjury tissue samples were collected and stained with trichrome elastin and for isoform-specific MMPs. RESULTS:After vascular injury, the intima:media (I:M) ratio was decreased in OVX rats receiving placebos as compared with non-OVX controls (P < 0.05). In OVX animals receiving HRT, estrogen with and without progesterone and progesterone alone slightly increased I:M ratio compared with placebo, although no significant difference was found in any HRT group. Injury-induced intimal expression of MMP-2 and -9 was decreased in OVX placebo animals compared with non-OVX controls (P < 0.05). MMP-2 and -9 levels were subsequently increased by each type of hormone therapy compared with placebo, with a significant increase in MMP-9 in response to estrogen with and without progesterone (P < 0.05). Conversely, TIMP-2 was decreased by estrogen compared with placebo (P < 0.05). There was no effect on intimal MT1-MMP in any group. CONCLUSIONS:In this study we detected a statistically significant decrease in IH as a result of OVX. Subsequent HRT exposure resulted in increased I:M ratios compared with OVX animals given placebo, although significance was not reached with the doses given. Long-term exogenous exposure may have a more deleterious effect compared with acute exposure and should be examined further. We also demonstrated a significant reduction in MMP-2 and -9 and TIMP-2 in response to OVX. Subsequent hormone exposure resulted in the upregulation of MMP-2 and -9 without a counterregulatory increase in TIMP, indicating that HRT modulates the MMP regulatory pathway in vivo. The data suggest that the lack of hormones after OVX protects against pathologic remodeling in our aged model of disease and that exposure to both natural and exogenous hormones could be a negative risk factor resulting in an exaggerated vascular response to injury. Future studies should focus on in vivo manipulation of unbalanced MMP regulation for prevention of IH in response to HRT and in general. Furthermore, the age-associated difference in response to the presence of natural hormones in young vs aged models should be investigated.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Mountain DJ,Freeman MB,Kirkpatrick SS,Cook RB,Chalk JE,Stevens SL,Goldman MH,Grandas OHdoi
10.1016/j.avsg.2012.05.010subject
Has Abstractpub_date
2013-04-01 00:00:00pages
337-45issue
3eissn
0890-5096issn
1615-5947pii
S0890-5096(12)00332-9journal_volume
27pub_type
杂志文章abstract::Infection of an aortic endoprosthesis is a potentially lethal complication of an endovascular abdominal aortic aneurysm repair (EVAR). Surgical treatment usually involves excision of the infected endograft and vascular reconstruction, either in-line or extraanatomic. We present a case of severe infection of an endogra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.09.007
更新日期:2013-07-01 00:00:00
abstract::Although the histologic effects of balloon catheter thromboembolectomy in arteries are well described, little is known about its effects on arterialized vein grafts. A chronic canine model was used to compare the intimal hyperplasia that develops following balloon catheter thrombectomy versus thrombolytic therapy when...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900091
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.09.015
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:This report examines the effects of regional versus general anesthesia for infrainguinal bypass procedures performed in the treatment of critical limb ischemia (CLI). METHODS:Nonemergent infrainguinal bypass procedures for CLI (defined as rest pain or tissue loss) were identified using the 2005 to 2008 Amer...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.04.006
更新日期:2013-02-01 00:00:00
abstract::We present a case of abdominal aortic aneurysm open repair planned with temporary left ventricular support (Impella®) in a patient suffering from severe chronic heart failure. Only 1 single similar case was reported in the literature from 1974. ...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.05.060
更新日期:2020-11-01 00:00:00
abstract::The objective of this study was to assess the relationship of signaling molecules to monocyte/ macrophages as a precursor to venous valve and venous wall dysfunction in patients with varicose veins. One of the hallmarks of venous dysfunction is destruction of venous valves with subsequent reflux and elevation of dista...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910092
更新日期:2000-09-01 00:00:00
abstract::Iliac arterial disease, unfavorable anatomy, and prior stenting all pose challenges to access in endovascular abdominal aortic repair (EVAR) and thoracic aortic repair (TEVAR). Iliac access injury during T/EVAR may lead to rupture, dissection, thrombosis, or distal ischemia. Some have advocated iliac stent prior to T/...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.157
更新日期:2017-11-01 00:00:00
abstract::Ischemia occurring during hyperextension of the upper limb in a 25-year-old woman led to the discovery of a supracondylar spur responsible for compression of the brachial artery with anomalous insertion of the pronator teres muscle. Resection of all abnormal structures provided immediate relief of symptoms. When atypi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60736-X
更新日期:1987-05-01 00:00:00
abstract::Renal transplantation has increased the longevity of patients with uremia. An increasing number undergo aortic reconstruction, which exposes the transplanted kidney to ischemic injury. To evaluate the risk for renal failure, loss of the transplant, and methods of renal protection, we reviewed our experience. Clinical ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000752
更新日期:1996-03-01 00:00:00
abstract::Acute occlusion of the visceral arteries is a threatening complication following branched endovascular aortic repair (EVAR). Its prompt diagnosis and treatment are mandatory to restore renal function. Several techniques have been used to manage this complication. We report 2 clinical cases of patients, previously trea...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.07.015
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:As high healthcare costs are increasing scrutinized, a movement toward reducing patient hospital admissions and lengths of stay has emerged, particularly for operations that may be performed safely in the outpatient setting. Our aim is to describe recent temporal trends in the proportion of dialysis access p...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.07.032
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Starting in December 2013, the Hospital Inpatient Quality Reporting Program included Clostridium difficile infection (CDI) rates as a new publically reported quality measure. Our goal was to review the trend, hospital variability in CDI rates, and associated risk factors and costs in vascular surgery. METHO...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.10.031
更新日期:2015-01-01 00:00:00
abstract::Elective repair of abdominal aortic aneurysms (AAA) in the elderly has conventionally been associated with higher mortality rates than in younger patients, although some authors do not agree with this view. The aim of this study is to look into current results of surgical treatment in elderly patients with nonruptured...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s100160010082
更新日期:2001-05-01 00:00:00
abstract::The initial 37 consecutive patients to be treated at our institution with the Palmaz stent placed in the aortoiliac arteries were retrospectively reviewed. In these patients, 50 stenoses and six occlusions were treated with 128 stents. Nine patients with combined iliac and common femoral obstruction underwent common f...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000251
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:High glucose (HG)-induced endothelial dysfunction is a common pathologic process of vascular disease in patients with diabetes. HoxA9EC is a transcriptional regulator of genes involved in the stabilization of endothelial function. We sought to elucidate the effect of HG on HoxA9EC expression in human umbilic...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.011
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the adverse effects of iodixanol and iopamidol in terms of patient's discomfort in subjects undergoing carotid artery stenting (CAS). METHODS:We retrospectively analyzed data of all successful CAS procedures performed in our department during a 15-year period study. All ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.04.018
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The aim of this study is to compare 2 groups of patients treated for great saphenous vein (GSV) reflux with open surgical saphenofemoral ligation (SFL) and endovenous laser ablation (EVLA). METHODS:Consecutive patients with primary unilateral GSV reflux undergoing EVLA treatment since 2014 were enrolled, an...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.11.029
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:In recent years, endovascular treatment of subclavian artery pseudoaneurysm (SAP) has been recommended by many experts. The aim of this study is to evaluate the safety and efficacy of the endovascular treatment of SAP, and to introduce our experience in the diagnosis and treatment of SAP. METHODS:A total of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.10.096
更新日期:2020-05-01 00:00:00
abstract::Reported patency rates for paramalleolar bypass grafts have varied widely. To determine factors predictive of outcome, we reviewed our experience with 80 consecutive paramalleolar reconstructions in 68 patients performed between December 1986 and May 1995. All procedures were performed for critical limb ischemia defin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02286779
更新日期:1996-07-01 00:00:00
abstract::To evaluate the impact of central venous obstruction on upper extremity hemodialysis access failure, we retrospectively analyzed our recent experience in managing this problem. We reviewed 158 upper extremity hemodialysis access procedures performed in 122 patients during a 1-year period. Fourteen (11.5%) patients had...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02017408
更新日期:1994-11-01 00:00:00
abstract::The purpose of this review is to define animal models of chronic venous disease and to demonstrate how animal studies can impact our understanding and treatment of this disorder. To this end an extensive literature search was conducted highlighting potential animal models of chronic lower extremity venous disease. Sci...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s100169900190
更新日期:1998-09-01 00:00:00
abstract::A 12-year-old boy with a family history of hereditary multiple exostosis presented with a 3-week history of progressive knee swelling. The clinical examination revealed drop foot and a loss of extension in his right knee. Evaluation with color duplex ultrasonography, computed tomography angiography, and magnetic reson...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.08.018
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Sex-related differences in outcomes have been identified in patients with peripheral artery disease (PAD). We hypothesized that women with PAD would have equivalent inpatient mortality with men after vascular intervention. METHODS:Patients with a primary diagnosis of critical limb ischemia (CLI) or lifestyl...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.01.006
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:A number of surgical strategies and graft enhancements have been trialled to improve the performance of prosthetic grafts. Neointimal hyperplasia may, in part, be a normal cellular response to an abnormal (turbulent) flow environment. This first-in-many study assesses the safety and medium-term patency perfo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2012.02.001
更新日期:2012-11-01 00:00:00
abstract::Twenty-four patients who underwent surgery for pararenal aortic aneurysms between January 1992 and April 1997 are reviewed. Eighteen patients had primary atherosclerotic aneurysms, three patients had symptomatic infected aneurysms, two patients had an aneurysm proximal to a prior aortic repair, and one patient had a p...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900164
更新日期:1998-07-01 00:00:00
abstract::Arterial aneurysm formation occurs in 15 to 20% of patients with Takayasu's disease. The timing of surgical intervention of these aneurysms is controversial. A case of ectasia of the descending thoracic aorta in a patient with Takayasu's disease is presented. The diagnosis and timing of surgical intervention of aneury...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02133055
更新日期:1991-09-01 00:00:00
abstract::Traditional methods for revascularization of an occluded aortoiliac system have necessitated either in-line aortic reconstruction through an aortobifemoral bypass or extra-anatomic bypass. However, both these approaches require artificial material to be placed in the groin. The consequence of groin infection can be de...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.09.023
更新日期:2011-04-01 00:00:00
abstract::Prolonged use of fibrinolytic agents post thrombectomy is limited by present techniques that require arterial puncture and indwelling arterial catheters. This limitation can be avoided by attaching a short segment of saphenous vein to the arteriotomy used for the thrombectomy and bringing this out to the skin as a "ve...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900089
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:We performed a systematic review and meta-analysis to examine whether patients with intermittent claudication can benefit from endovascular treatment (EVT). METHODS:A prespecified search strategy was used to identify relevant studies in the MEDLINE, Embase, and Cochrane databases. A total of 10 different ra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.avsg.2013.05.022
更新日期:2014-05-01 00:00:00
abstract::Endovascular repair of peripheral arterial lesions was performed in 10 patients including two iliac aneurysms, two iliac anastomotic pseudoaneurysms, one subclavian pseudoaneurysm, one axillary anastomotic disruption, two prosthetic pseudoaneurysms, and two posttraumatic arteriovenous (AV) fistulas. The indications fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900043
更新日期:1997-05-01 00:00:00