Time-Dependent thickening of the intima in aortocoronary saphenous vein grafts: Clinicopathological analysis of 24 patients

Abstract

The present study was undertaken to investigate histological changes in aortocoronary saphenous vein grafts (SVGs) and the relationship between intimal thickening of the SVGs and the interval after grafting. The SVGs were divided into five groups according to the degree of intimal thickening and associated luminal narrowing: minimal thickening (0%-10% stenosis), slight thickening (11%-25% stenosis), slight-to-moderate thickening (26%-50% stenosis), moderate thickening (51%-75% stenosis), and severe thickening (76%-100% stenosis). SVGs showing minimal thickening had been implanted for 0-3 weeks, those with slight thickening for 2-13 weeks, those with slight-to-moderate thickening for 5-13 weeks, those with moderate thickening for 30-52 weeks, and those with severe thickening for 30-83 weeks. Thickening of the intima in SVGs (intimal hyperplasia) was time-dependent, and began as early as 2 weeks after the graft surgery. The change was diffuse and concentric, and observed from an aortic root to a coronary site. The major cell type involved in the intimal hyperplasia was the smooth muscle cell.

Mechanisms of death in the early postoperative period following coronary artery bypass grafting for acquired heart disease. A clinicopathological study of 32 cases

“…Despite extensive investigations in this field since the introduction of CABG in the late 1960s, only relatively few clinicopathological studies on causes of death and complications have yet been reported [6,16,18,29]. This may partly be explained by the fact that in the last decades the autopsy rate has shown continual declination in the western world.…”

“…Morphological studies on changes after CABG have mainly been done on venous grafts [1,2,10,14,17,18,20,23,25,27,28,29]. It has been noted that damage of the endothelium of the graft [14], placement of a disproportionate graft on a small coronary artery [28], or distal anastomosis on an arteriosclerotically stenosed coronary artery segment with subsequent decreased flow [9] may result in occlusive thrombosis.…”

Procedural Results and Distal Embolization After Saphenous Vein Graft Stenting and Angioplasty for Instent Restenosis of Grafts

“…23) After angioplasty, the graft response varies in relation to the age of the graft. [23][24][25] In the first month, graft failure is usually due to thrombosis secondary to technical operative factors. In the first year, intimal thickening occurs.…”

Lumen Loss in the First Year in Saphenous Vein Grafts Is Predominantly a Result of Negative Remodeling of the Whole Vessel Rather Than a Result of Changes in Wall Thickness

“…14 Furthermore, the change in lumen diameter is modifiable. 15 IVUS and pathology studies have described an increase in SVG intima area 16 and adventitia 17 days to weeks after implantation. 4 Pathology studies have shown that differences in the wall thickness of grafts are predominantly caused by differences in thickness of the intima, rather than of the media or adventitia.…”