Effect of oral L-Arginine supplementation on intima hyperplasia after Fogarty balloon embolectomy catheterization in New Zealand Rabbit (Oryctolagus cuniculus)

Abstract

Background: Acute limb ischemic is a disease that threatens the viability of the leg with the threat of amputation to death. Fast and accurate diagnosis is essential in the management of this disease, one of the most commonly performed surgical therapies in Indonesia is thromboembolectomy using a Fogarty catheter. Thromboembolectomy with this method is very effective but gives a variety of complications, one the complication is the occurrence of intima hyperplasia which affects the lumen restenosis of the blood vessels. The aim of this study is to determine whether the administration of oral L-Arginine as a supplement for 4 weeks after endothelial trauma with a Fogarty embolectomy balloon catheter can prevent the incidence of intimal hyperplasia of the iliac artery of the New Zealand Rabbit (Cuniculus oryctolagus).Methods: Experimental study with 16 experimental animals of Oryctolagus cuniculus rabbits subjected to endothelial trauma with Fogarty catheters and divided into 2 groups. The control group was not given L-Arginine and the experimental group was given post-treatment oral L-Arginine for 4 weeks, then the intima-media ratio was compared with histopathological examination.Results: There was a significant difference in the ratio of intima-media thickness between the control group (without L-Arginine administration) 5.13 ± 4.12 and the experimental group (with L-Arginine administration) 1.18 ± 0.59 (p=0.03 ). Significant differences were also found in the intima thickness of the control group 302.22 ± 217.42 and the experimental group 118.21 ± 32.59 (p=0.048). Meanwhile, for the thickness of the tunica media and the intima-media complex, there were no significant differences observed.Conclusion: Administration of L-Arginine orally after endothelial trauma with Fogarty catheter in rabbit iliac artery significantly reduces the degree of intima hyperplasia.

Investigation of the effect of acute to chronic glycemic ratio on major amputation development after surgical thromboembolectomy in patients with acute lower extremity ischemia

“…In an experimental study model on rabbits, the development of intimal hyperplasia due to a Fogarty balloon catheter was demonstrated histopathologically. 19 In a case report by Smith et al, a case of progressive intimal hyperplasia developing in the third month after embolectomy was reported. 20 In our study, we identified early re-embolectomy as an independent predictor of amputation development, in both multivariate analysis models.…”