Remodeling leads to distinctly more intimal hyperplasia in coronary than in infrainguinal vein grafts

Zilla, Peter; Moodley, Loven; Scherman, Jacques; Krynauw, Hugo; Kortsmit, Jeroen; Human, Paul; Wolf, Michael; Franz, Thomas

doi:10.1016/j.jvs.2011.11.057

Cited by 17 publications

(23 citation statements)

References 20 publications

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“…NH has been well examined in coronary bypass grafts but is different for peripheral surgery in terms of flow patterns, blood pressure and graft length (Westerband et al 2000;Zilla et al 2012). Altered shear stress may even be protective against hyperplasia but did not prevent graft failure in our patients.…”

Section: Discussionmentioning

confidence: 99%

Neointimal hyperplasia in allogeneic and autologous venous grafts is not different in nature

Albert

Hartmann

Wagner

et al. 2015

Histochem Cell Biol

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Neointimal hyperplasia, transplant rejection and thus immunogenicity of allografts are possible reasons for poorer patency rates in cryopreserved venous allografts for peripheral bypass surgery in comparison with autologous venous grafts. To expand the limited knowledge from human allografts, we histologically investigated allogeneic and autologous venous grafts in arterial location. Specimens of allogeneic and autologous venous graft stenosis, harvested 6 months after bypass implantation, were immunohistochemically characterized. Examination of the lesions showed a uniform morphological pattern. A continuous endothelial layer, tissue fibrosis and a thickened neointima with monocytes and dedifferentiated vascular smooth muscle cells were seen in both conduits with very low cell turnover and the absence of acute and chronic inflammation. Neoangiogenesis with CD34-positive endothelium was abundant in the vessel media. The morphological patterns of allogeneic and autologous neointima formation are similar. Consequently, neointimal hyperplasia in venous grafts may reflect a uniform physiological host response of non-immunological factors with the reasons for poorer clinical outcome of cryopreserved allografts yet to be elucidated.

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Section: Discussionmentioning

confidence: 99%

Neointimal hyperplasia in allogeneic and autologous venous grafts is not different in nature

Albert

Hartmann

Wagner

et al. 2015

Histochem Cell Biol

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“…Our ex vivo system also allows for compensation for the possible influence that different anatomical locations may have on the arterialization of grafted veins, providing a unique platform to explore the different factors that may contribute to modify the grafted vessels. 3,25 Remodeling requires the integrated effects of the fibrinolytic system, MMPs, and their inhibitors. We have shown that elevation of PAI-1 26 is induced by the arterial shear stress and, in contrast to IH, is not markedly influenced by the hemodynamic pressure.…”

Section: Discussionmentioning

confidence: 99%

Role of hemodynamic forces in the ex vivo arterialization of human saphenous veins

Bérard

Déglise²,

Alonso³

et al. 2013

Journal of Vascular Surgery

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The pathological remodeling of the venous wall, which leads to stenosis and ultimately graft failure, is the main limiting factor of human saphenous vein graft bypass. This remodeling is due to the hemodynamic adaptation of the vein to the arterial environment and cannot be prevented by conventional therapy. To develop a more targeted therapy, a better understanding of the molecular mechanisms involved in intimal hyperplasia is essential, which requires the development of ex vivo models of chronic perfusion of human veins.

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“…(Takumi et al 2010) While compensatory remodeling of coronary vasculature initially maintains shear stress, (Dolan et al 2012; Huo and Kassab 2012; Samady et al 2011) remodeling-mediated neointimal hyperplasia is conducive to the development of high shear stress in response to reduced vessel lumen diameters. (Zilla et al 2012) The presence of pre-atherosclerotic lesions further engenders disturbed flow downstream to the stenosis, (Varghese and Frankel 2003; Zhang 2009) recruiting monocyte and LDL particles transmigration into the subendothelial layers (Ai et al 2009; Davies et al 1986) as well as promoting atherothrombosis. (Bark Jr and Ku 2010) Using the ApoE knockout mouse model with the constrictive carotid artery collars, Ding et al reported elevated shear stress within the constrictive regions and low shear stress at proximal regions coupled with endothelial disfunction(Ding et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Elevated electrochemical impedance in the endoluminal regions with high shear stress: Implication for assessing lipid-rich atherosclerotic lesions

Lee

Jen

et al. 2013

Biosensors and Bioelectronics

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Background Identifying metabolically active atherosclerotic lesions remains an unmet clinical challenge during coronary intervention. Electrochemical impedance (EIS) increased in response to oxidized low density lipoprotein (oxLDL)-laden lesions. We hereby assessed whether integrating EIS with intravascular ultrasound (IVUS) and shear stress (ISS) provided a new strategy to assess oxLDL-laden lesions in the fat-fed New Zealand White (NZW) rabbits. Methods and Results A micro-heat transfer sensor was deployed to acquire the ISS profiles at baseline and post high-fat diet (HD) in the NZW rabbits (n=8). After 9 weeks of HD, serum oxLDL levels (mg/dL) increased by 140-fold, accompanied by a 1.5-fold increase in kinematic viscosity (cP) in the HD group. Time-averaged ISS (ISSave) in the thoracic aorta also increased in the HD group (baseline: 17.61±0.24 vs. 9 weeks: 25.22±0.95 dyne/cm2, n=4), but remained unchanged in the normal diet group (baseline: 22.85±0.53 dyne/cm2 vs. 9 weeks: 22.37±0.57 dyne/cm2, n=4). High-frequency Intravascular Ultrasound (IVUS) revealed atherosclerotic lesions in the regions with augmented ISSave, and concentric bipolar microelectrodes demonstrated elevated EIS signals, which were correlated with prominent anti-oxLDL immuno-staining (oxLDL-free regions: 497±55 Ω, n = 8 vs. oxLDL-rich lesions: 679±125 Ω, n = 12, P < 0.05). The equivalent circuit model for tissue resistance between the lesion-free and ox-LDL-rich lesions further validated the experimental EIS signals. Conclusions By applying electrochemical impedance in conjunction with shear stress and high-frequency ultrasound sensors, we provided a new strategy to identify oxLDL-laden lesions. The study demonstrated the feasibility of integrating EIS, ISS, and IVUS for a catheter-based approach to assess mechanically unstable plaque.

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Remodeling leads to distinctly more intimal hyperplasia in coronary than in infrainguinal vein grafts

Abstract: Although coronary and infrainguinal bypass surgery uses saphenous veins as conduits, they undergo significantly different remodeling processes in these two anatomic positions.

Cited by 17 publications

References 20 publications

Neointimal hyperplasia in allogeneic and autologous venous grafts is not different in nature

Neointimal hyperplasia in allogeneic and autologous venous grafts is not different in nature

Role of hemodynamic forces in the ex vivo arterialization of human saphenous veins

Elevated electrochemical impedance in the endoluminal regions with high shear stress: Implication for assessing lipid-rich atherosclerotic lesions

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