Results of the Biterminal Transplantation of Veins

Carrel, Alexis; Guthrie, C. C.

doi:10.1097/00000441-190609000-00006

Cited by 62 publications

(17 citation statements)

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“…Other studies, investigating the effects of mechanical stim ulation on SMCs from various tissues, have shown that airway SMCs [43], coronary artery SMCs [44] and neona tal rat vascular SMCs [45] proliferate in response to pulsa tile stretch while a regimen of repetitive stretch had no sig nificant effect on pulmonary arterial SMC proliferation [46], The strain-induced growth in neonatal rat vascular SMCs is attributed to the stretch-induced secretion of platelet-derived growth factor AA [45], Vein graft thickening in the arterial circulation is an adaptive process and may be of eentral importance in the development of pathologic fibrous stenoses [47], This adaptive process has often been referred to as 'arterialization' but the use of this term is inappropriate [48,49], By comparing the histological features of normal veins with veins inserted as grafts into the arterial circulation it is possible to show that veins do not become arteries [50]. Grafted veins become thicker as they adapt to arterial cir culation [48], and cease remodeling once the wall of the grafted vein reaches the same thickness as the adjacent artery [47,51]. However, the grafted veins become noncompliant and inhomogeneous, and do not assume either the elastic or the histological characteristics of arterial tis sue [52], Additionally, intimal hyperplasia is found within the coronary artery, distal to the bypass venous graft, which further suggests that the process is not one of arterialization [53].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Mechanical Stimulation on Venous and Arterial Smooth Muscle Cells in vitro

Dethlefsen

Shepro

D’Amore³

1996

J Vasc Res

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The proliferation of intimal smooth muscle cells (SMCs) in large muscular arteries and veins often occurs after surgical interventions such as angioplasty and bypass grafting, and may lead to restenosis and graft failure. Clinical observations suggest that increased pulsatile deformation of veins grafted into an arterial position may play a role in intimal hyperplasia. Since intimal hyperplasia occurs at the vein/arterial interface of the graft, SMC hyperplasia could be due to the proliferation of either aortic or venous SMCs. Therefore, we compared the effects of in vitro mechanical deformation on the proliferation of aortic SMCs with venous SMCs. Using the Flexercell^R apparatus (Flex-cell Corp., McKeesport, Pa., USA), aortic SMCs, stretched at 3 and 60 cpm did not lead to a significant increase in growth as compared to the non-stretched controls. In contrast, stretch of venous SMCs at 3 and 60 cpm led to a significant increase in growth as compared to the nonstretched controls. These results suggest that the SMC proliferation, as occurs in vein interposition grafts in vivo, may be partially due to a stimulatory response by venous SMCs to increased mechanical stimulation.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Mechanical Stimulation on Venous and Arterial Smooth Muscle Cells in vitro

Dethlefsen

Shepro

D’Amore³

1996

J Vasc Res

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“…Whether these events have more to do with decreased availability of growth factor or increased accumulation of inhibitor is not known. ( 14,40,41 ). Furthermore, wall thickening can be controlled to some extent by high blood flow (37).…”

Section: Discussionmentioning

confidence: 99%

Long-term biological response of injured rat carotid artery seeded with smooth muscle cells expressing retrovirally introduced human genes.

et al. 1994

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Cultured vascular smooth muscle cells (SMCs) containing retrovirally introduced genes are a potential vehicle for gene replacement therapy. Because the cultured SMCs are selected for their ability to proliferate in vitro, it is possible that the SMCs might be permanently altered and lose their capacity to respond to growth-suppressing conditions after being seeded back into blood vessels. To investigate this possibility we measured SMC proliferation and intimal thickening in balloon-injured Fischer 344 rat carotid arteries seeded with SMCs stained with the fluorescent marker 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI) and infected with replicationdefective retrovirus expressing human adenosine deaminase or human placental alkaline phosphatase. The majority of the seeded SMCs remained in the intima while a few of the cells appeared to migrate into the first layer of the media. Intimal SMC proliferation returned to background levels (< 0.1% thymidine labeling index) by 28 d. At late times (1 and 12 mo) the morphological appearance of the intima was the same for balloon-injured arteries with or without seeded SMC, except that the seeded arteries continued to express human adenosine deaminase or alkaline phosphatase. These results support the conclusion that cultured SMC infected with a replication-defective virus containing human adenosine deaminase or alkaline phosphatase are not phenotypically altered and do not become transformed. After seeding onto the surface of an injured artery, they stop replicating but continue to express the introduced human genes even over the long term. (J. Clin. Invest.

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“…CARREL & GUTHRIE (6) descreveram, em 1906, o espessamento intimal das veias implantadas em cães, e concluíram que as veias colocadas na circulação arterial tinham uma forte tendência para assumir o cateter de uma artéria. Dois anos mais tarde, o mesmo CARREL (7) descreveu quatro alterações características nas veias usadas como artérias nas veias periféricas, tais como, (a) espessamento intimal, (b) espessamento da adventícia, (c) perda do terço interno da camada média e (d) perda da elasticidade da veia transformandoa num tubo fibroso.…”

Section: Fisiopatologiaunclassified

Optimização da perviabilidade do enxerto venoso na revascularização miocárdica: compreensão da fisiopatologia, novas drogas e avanços técnicos

Loures¹,

Ribeiro²,

Mulinari³

et al. 2001

Rev Bras Cir Cardiovasc

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da perviabilidade do enxerto venoso na revascularização miocárdica: compreensão da fisiopatologia, novas drogas e avanços técnicos. Rev Bras Cir Cardiovasc 2001; 16(1): 14-9. RESUMO: Objetivo: Baseado nos modernos conceitos do comportamento endotelial do enxerto venoso, o objetivo deste trabalho foi identificar quais os principais fatores de obstrução no período imediato da cirurgia, quais e quando ocorrem as modificações morfológicas tardias e, finalmente, apontar os recursos aplicáveis para optimizar a perviabilidade imediata e tardia dos enxertos venosos.Casuística e Métodos: No período de 1971 a 1998 foram operados 3116 pacientes de revascularização miocárdica. Estes procedimentos foram analisados em três grupos-grupo I onde somente se empregou veia safena; grupo II onde somente se empregou artéria torácica interna e grupo III onde se empregou a associação de veia safena e artéria torácica interna. A incidência de reoperações foi analisada procurando identificar a perviabilidade dos diferentes enxertos e seus resultados. Foi realizada uma análise estatística empregando-se o teste de Qui-quadrado para averiguar a existência de diferenças de reoperados e mortalidade entre os três grupos.Resultados: O índice de mortalidade imediata variou de 1 a 7% no grupo I para 3,8 % no grupo II demonstrando diferença estatisticamente significativa (p= 0,0401). Foram reoperados 255 pacientes, sendo 3,8% no grupo II e 8,1% no grupo I demonstrando diferença estatisticamente significativa (p= 0,0094).Conclusões: Os resultados imediatos com os enxertos venosos dependem do manuseio cirúrgico, retirada. e preparo da veia, confecção das anastomoses e qualidade das artérias coronárias. Os resultados tardios entre o quinto e décimo anos sofrem a influência do espectro da aterosclerose. Os enxertos venosos representam maior incidência de reoperações quando comparados com os enxertos arteriais. Os enxertos venosos podem aumentar o grau de perviabilidade através da limitação do manuseio da veia safena, emprego de drogas como verapamil, triglicerina, papaverina, aprotinina, da profilaxia da aterosclerose e da uniformização da luz das veias irregularmente dilatadas através de enxertos tubulares híbridos.

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Results of the Biterminal Transplantation of Veins

Cited by 62 publications

References 0 publications

Comparison of the Effects of Mechanical Stimulation on Venous and Arterial Smooth Muscle Cells in vitro

Comparison of the Effects of Mechanical Stimulation on Venous and Arterial Smooth Muscle Cells in vitro

Long-term biological response of injured rat carotid artery seeded with smooth muscle cells expressing retrovirally introduced human genes.

Optimização da perviabilidade do enxerto venoso na revascularização miocárdica: compreensão da fisiopatologia, novas drogas e avanços técnicos

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