Biologic Fate of Autogenous Vein lmplants as Arterial Substitutes

Szilagyi, D. Emerick; Elliott, Joseph P.; Hageman, John H.; Smith, Roger; Dall'Olmo, Carlo A.

doi:10.1097/00000658-197309000-00002

Cited by 545 publications

(46 citation statements)

References 14 publications

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“…Arterialised veins are more likely to develop atherosclerotic disease, which may lead to vein graft failure [20]. The risk of vein graft failure is estimated to be around 50% over 10 years in coronary arterial disease and approximately 30% over 1 year for peripheral arterial disease [21,22,23]. …”

Section: Morphological Effects Of Mechanical Stretch On Blood Vesselsmentioning

confidence: 99%

The Effect of Pressure-Induced Mechanical Stretch on Vascular Wall Differential Gene Expression

et al. 2012

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High blood pressure is responsible for the modulation of blood vessel morphology and function. Arterial hypertension is considered to play a significant role in atherosclerotic ischaemic heart disease, stroke and hypertensive nephropathy, whereas high venous pressure causes varicose vein formation and chronic venous insufficiency and contributes to vein bypass graft failure. Hypertension exerts differing injurious forces on the vessel wall, namely shear stress and circumferential stretch. Morphological and molecular changes in blood vessels ascribed to elevated pressure consist of endothelial damage, neointima formation, activation of inflammatory cascades, hypertrophy, migration and phenotypic changes in vascular smooth muscle cells, as well as extracellular matrix imbalances. Differential expression of genes encoding relevant factors including vascular endothelial growth factor, endothelin-1, interleukin-6, vascular cell adhesion molecule, intercellular adhesion molecule, matrix metalloproteinase-2 and -9 and plasminogen activator inhibitor-1 has been explored using ex vivo cellular or organ stretch models and in vivo experimental animal models. Identification of pertinent genes may unravel new therapeutic strategies to counter the effects of pressure-induced stretch on the vessel wall and hence minimise its notable complications.

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Section: Morphological Effects Of Mechanical Stretch On Blood Vesselsmentioning

confidence: 99%

The Effect of Pressure-Induced Mechanical Stretch on Vascular Wall Differential Gene Expression

et al. 2012

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“…The use of saphenous veins for arterial bypass grafting surgery has stimulated interest in the normal structure of these vessels in human and in canine models. The struc tural modifications of the transplanted veins are of particular importance because of loss of elasticity in grafted veins [2,4,20]. Other pathological conditions (aneurysms, hyper tension and calcification in atherosclerosis) also have been linked to the breakdown of the mural elastic components [5,19].…”

Section: Introductionmentioning

confidence: 99%

The Three-Dimensional Configuration of the Elastic Fiber Network in Canine Saphenous Vein

Crissman¹

1984

J Vasc Res

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Stereo scanning electron microscopy was used to study the normal arrangement of elastic fibers in canine saphenous veins. Selective alkali digestion and autoclaving exposed a network of interconnecting elastic fibers throughout the venous wall. 14 normal saphenous veins were surgically removed from 7 healthy dogs. Unfixed 1-cm segments of the isolated specimens were digested by sonication for 30 min in 0.5 TV NaOH solution and then autoclaved for 30 min. The digested specimens were then fixed and routinely prepared for scanning electron microscopy. Large longitudinally oriented fibers in each tunica branched and anastomosed with adjacent fibers. Small fibers branched off at almost right angles and interconnected the longitudinal fibers. The configuration of the elastic network varied between the tunicae of the venous wall. The different networks were interconnected by anastomosing fibers of adjacent tunica to form a single elastic cylinder throughout the venous wall. The internal elastic lamina consisted of a single layer of fibers with a fishnet-like arrangement around the periphery of the luminal surface. Large, longitudinally oriented elastic fibers of the tunica media branched and anastomosed as in the internal elastic lamina. However, they also had tangential orientation and traversed different levels within the media. As a result, stratified layers were not formed. The external lamina consisted of several parallel layers of longitudinally oriented ribbons of elastic. Thick fibers interconnected these broad ribbons on the same and adjacent levels to form discontinuous layers. The configuration of the elastic network of the canine saphenous vein is compared to that previously reported for human saphenous vein. It is suggested that the architecture of this elastic network would contribute to vascular integrity and flexibility as well as aid in the distribution of stress throughout the venous wall. Basic knowledge of the elastic fiber network in this vein may be applied to future studies of diseased and grafted vessels.

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“…When severe, it progresses to overt atherosclerosis at times associated with thrombosis and aneurysm formation. 10 " 13 The relationship of phlebosclerosis to atherosclerosis is controversial, but the former appears to merge into the latter, with no sharp line of demarcation. The difference seems to be one of degree and both are accentuated by hypertension and hemodynamic parameters.…”

Section: Resultsmentioning

confidence: 99%

Chronic vascular changes in the walls of experimental berry aneurysms of the aortic bifurcation in rabbits.

Stehbens¹

1981

Stroke

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SUMMARY Experimental berry aneurysms were fashioned from an autogenous venous transplant by microvascular surgery at the aortic bifurcation of rabbits maintained on a stock diet. Structural changes in the aneurysms and in the host aorta were studied for periods up to 3 years 9 months postoperarJTely. Phlebosclerosis developed in the aneurysms and progressed to severe flbrosis, calcification, ossification, mural thrombosis and llpid deposition resembling human atherosclerosis, with eventual loss of the media. CONTROVERSY continues over the etiology of berry aneurysms of the cerebral arteries, partly because of difficulties in understanding the structure of the sac wall. 1 '' Since berry aneurysms are rare in animals other than man, 8 experimental aneurysms were fashioned by microvascular surgery at the rabbit aortic bifurcation to study structural changes in their walls when subjected to chronic hemodynamic stress peculiar to this type of aneurysmal dilatation. Materials and MethodsAnesthesia, induced in 21 young stock rabbits (2 to 3 kg in weight) by intravenous sodium pentobarbital, was sustained by open ether. A segment of the external jugular vein, previously mobilized from the neck and free of valves, was anastomosed aseptically in the crotch (apical angle 2 ) of the aortic bifurcation, and adjacent medial aspect of the common iliac arteries to form an end-to-end anastomosis in relation to the aorta. The free end of the vein was then ligated. The size of the sac could be varied and, by means of 2 such ligatures, a small, blind, blood-filled venous sac was left in situ in 12 rabbits. Further details of this technique have been published. 4 The iliolumbar arteries arising from the lateral aspect of the common iliac arteries near the fork were ligated routinely.The rabbits were fed on a stock pellet diet with water ad libitum and were killed by intravenous sodium pentobarbital at intervals varying from 1 day to 3 years 9 months postoperatively. The abdominal aorta with the aneurysm was removed but, in some rabbits, the aorta was perfused with fixative for a few minutes prior to removal. All tissues were fixed in 10% buffered formalin.Step serial blocks were cut transversely through the lower abdominal aorta and aneurysm in 6 rabbits, and tissues were embedded in paraffin or gelatin. In the remaining 19 rabbits,

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Biologic Fate of Autogenous Vein lmplants as Arterial Substitutes

Cited by 545 publications

References 14 publications

The Effect of Pressure-Induced Mechanical Stretch on Vascular Wall Differential Gene Expression

The Effect of Pressure-Induced Mechanical Stretch on Vascular Wall Differential Gene Expression

The Three-Dimensional Configuration of the Elastic Fiber Network in Canine Saphenous Vein

Chronic vascular changes in the walls of experimental berry aneurysms of the aortic bifurcation in rabbits.

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