Mg. Davies et al., INFLUENCE OF PERIOPERATIVE CATHETER INJURY ON THE LONG-TERM VEIN GRAFT FUNCTION AND MORPHOLOGY, The Journal of surgical research, 66(2), 1996, pp. 109-114
Background: It has been shown that suboptimal preparation of a vein gr
aft prior to its insertion results in immediate morphological and func
tional damage to both endothelial cells and underlying smooth muscle c
ells. This study examines the influence of perioperative balloon cathe
ter injury on the subsequent development of intimal hyperplasia and va
somotor function in experimental vein grafts, Methods: Twenty New Zeal
and White rabbits had a carotid vein bypass graft performed: 10 were c
ontrols and 10 had a balloon catheter passed through their lumen which
resulted in deendothelialization and intramural injury (4Fr Fogarty c
atheter, 0.6-0.75 mi H2O inflation, three passes), All grafts were har
vested after 28 days for either morphology (n = 6) or functional studi
es (n = 4; four 5-mm rings/graft). Results: Perioperative balloon inju
ry of the vein graft resulted in a 23% increase in the intimal thickne
ss (102 +/- 7 mu m vs 83 +/- 2 mu m, deendothelialized vs control; mea
n +/- SEM, P < 0.01) and a 67% increase in medial thickness (144 +/- 1
9 mu m vs 86 +/- 8 mu m; mean +/- SEM, P < 0.01) of the vein grafts, B
oth the sensitivity and maximal contraction of the responses elicited
by norepinephrine, serotonin, and bradykinin were increased in the dee
ndothelialized group compared to controls. Conclusion: Perioperative d
enuding balloon injury of the vein graft results in the increased deve
lopment of intimal hyperplasia with an overall enhanced contractility,
This study demonstrates the long-term structural and functional effec
ts of perioperative balloon catheter injury on vein grafts that may co
ntribute to decreased graft patency. (C) 1996 Academic Press