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Vein interposition cuffs decrease the intimal hyperplastic response of polytetrafluoroethylene bypass grafts.

Abstract：

PURPOSE:The modification of the distal anastomosis of polytetrafluoroethylene (PTFE) bypass grafts with vein interposition cuffs (VCs) has been reported to increase graft patency. However, the mechanisms that are responsible for this improved patency are unclear. Because intimal hyperplasia (IH) is a primary cause of prosthetic graft failure, we hypothesized that VCs affect the distal anastomosis by decreasing the IH response of the outflow artery. METHODS:Twenty-three female domestic Yorkshire pigs (mean weight, 35 kg) underwent 42 femoral PTFE bypass grafting procedures. The PTFE bypass grafts were separated into the following three groups according to distal anastomotic configuration: end-to-side anastomoses (ES), VCs, and cuffs constructed with PTFE (PCs). Four femoral arteries from two pigs served as healthy controls. At sacrifice, the grafts were perfusion fixed, and the distal anastomoses harvested at 1 and 4 weeks. The specimens were hemisected and serially sectioned to identify the heel, toe, and mid-anastomotic regions. The sections were cut into 5-microm segments and analyzed for intima and media thickness and area, intima/media area ratio, and the distribution of IH in the vein cuff. The roles of transforming growth factor-beta1 and platelet-derived growth factor-BB in IH development were assessed with immunohistochemistry. RESULTS:IH development was significantly lower at all areas of the anastomosis, with VCs compared with ES and PCs at 4 weeks (P

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Kissin M,Kansal N,Pappas PJ,DeFouw DO,Durán WN,Hobson RW 2nd

doi

10.1016/s0741-5214(00)70069-3

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

69-83

issue

1 Pt 1

eissn

0741-5214

issn

1097-6809

pii

S0741521400717526

journal_volume

31

pub_type

杂志文章

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