J Korean Soc Vasc Surg.  2002 Nov;18(2):243-250.

Prevention of Autologous Vein Graft Atherosclerosis Thru Cell Cycle Inhibition

• Kim DS
• Park SH
• Jang JW
• Won YS
• Ahn H
• Youm W

Abstract

PURPOSE: Autologous vein graft is the most commonly used conduit for surgical revascularization of the small and medium sized vessels of the coronary and lower extremity circulations. But, 30~50% of these grafts succumb eventually to occlusive failure, often with recurrent morbidity that necessitates reoperation. The cause of failure is the vein graft atherosclerosis from the neointimal hyperplasia, which is the arterial remodeling process through adaptive thickening of the vein wall in response to the increased wall stress. We try to use cis-platin, DNA binding cell cycle specific inhibitory agent, against neointimal hyperplasia in experimental model. METHOD: 5 korean dogs had a autologous vein graft interposition at femoral or carotid arteries using saphenous or jugular veins bilaterally. One side of pairs is treated with cis-platin for one hour (study), while the other is not (conrol). After 4 weeks, we explanted 6 pairs of vein graft (3 jugular veins and 3 saphenous veins), and measured intimal thickness, intimal area and luminal area using videomorphometry, and analysed intimal ratio and luminal ratio. RESULT: Treatment with cis-platin reduced intimal thickness by 44% (P=0.0118) and intimal area by 50% (P=0.0124). Intimal ratio was decreased in the study group when compared to the control group by 0.18 versus 0.66 (P=0.001). The luminal area of the treated grafts was significantly larger than controls, having increased by 823% (P=0.0307), and luminal ratio having increased by 0.82 versus 0.34 (P=0.001).
CONCLUSION
These results suggest that cis-platin reduced the development of neointimal hyperplasia in experimental vein grafts. In order to prove the obtained results to a higher degree, an accumulation of further cases is necessary.

Keyword

Autologous; Vein; Graft; Atherosclerosis; Neointima; Hyperplasia

MeSH Terms

Animals
Atherosclerosis*
Carotid Arteries
Cell Cycle*
DNA
Dogs
Hyperplasia
Jugular Veins
Lower Extremity
Models, Theoretical
Neointima
Phenobarbital
Reoperation
Transplants*
Veins*
DNA
Phenobarbital