COMPLIANCE MISMATCH AND FORMATION OF DISTAL ANASTOMOTIC INTIMAL HYPERPLASIA IN EXTERNALLY STIFFENED AND LUMEN-ADAPTED VENOUS GRAFTS

Objective: Compliance and formation of distal anstomotic intimal hyper plasia (DAIH) were investigated in externally stiffened venous grafts of varying calibers. Methods: 36 femoropopliteal reconstructions were performed in 18 sheep. The autologous venous grafts were inserted into tubes made of Dacron mesh to achieve compliance-mismatch and lumen ad aptation Compliance tons measured by echo-tracked ultrasonography and profiles of DAIH were generated from histologic sections harvested aft er 8.3 months. Main results: The external mesh tube significantly lowe red the local compliance of graft and host artery. DAIH appeared exten sively in those groups where mesh tube constricted venous grafts met u ntreated host arteries (p = 0.002). No differences in compliance and D AIH formation were observed when grafts with large and adapted diamete rs were compared. Conclusions: For prevention of DAIH the distal venou s graft diameter is not important, while the local compliance of an au tologous vein is a predictive factor for DAIH formation and thus long- term patency.