The Ratio of Diameters Between the Target Artery and the Bypass Modifies Hemodynamic Parameters Related to Intimal Hyperplasia in the Distal End-to-Side Anastomosis

Grus, Tomáš; Lambert, Lukáš; Matěcha, J.; Grusová, Gabriela; Špaček, Miroslav; Mlček, Mikuláš

doi:10.33549/physiolres.933297

Cited by 10 publications

(11 citation statements)

References 27 publications

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“…A number of studies have been conducted using drugs to prevent intimal hyperplasia following balloon injury or stenting ( 22 , 23 ). Various mechanisms, including growth factors, inflammation, metabolic disorders and blood flow disturbances may cause intimal hyperplasia ( 24 ). Studies about the use of anagliptin for preventing intimal hyperplasia are novel and have not been published previously, however, positive results were obtained in the present study by using anagliptin in the prevention of intimal hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

The effect of anagliptin on intimal hyperplasia of rat carotid artery after balloon injury

et al. 2017

Molecular Medicine Reports

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The present study evaluated the effect of anagliptin on intimal hyperplasia following carotid artery injury in Sprague-Dawley rats. Sprague-Dawley rats weighing 280–300 g were injured using a 2F Fogarty balloon embolectomy catheter. The rats were divided into injury-(saline) and anagliptin-(10 mg/kg/day) treated groups. vascular injuries were induced in the left carotid artery, followed by evaluation of neointima formation at 28 days. The right and left carotid arteries were harvested and evaluated with histological evaluation, and the plasma activity of glucagon-like peptide 1 receptor (GLP-1), stromal cell-derived factor (SDF)-1α, interleukin (IL)-6, IL-1β and tumor necrosis factor (TNF)-α were detected by ELISA analysis. Treatment with anagliptin decreased balloon injury-induced neointima formation, compared with the injury group (P<0.01). Body weight and food consumption did not alter following treatment with anagliptin. Anagliptin caused an increase in the serum active GLP-1 concentration, compared with the injury group. In addition, serum SDF-1α was significantly decreased by treatment with anagliptin (P<0.001). Anagliptin altered the serum activity of IL-6, IL-1β and TNF-α (P<0.01). The results of the present study demonstrated that anagliptin appeared to attenuate neointimal formation by inhibiting inflammatory cytokines and chemokines following balloon injury, and that treatment with a dipeptidyl peptidase 4 inhibitor may be useful for future preclinical studies and potentially for the inhibition of thrombosis formation following percutaneous coronary intervention.

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Section: Discussionmentioning

confidence: 99%

The effect of anagliptin on intimal hyperplasia of rat carotid artery after balloon injury

et al. 2017

Molecular Medicine Reports

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“…The natural remodeling of the anastomosis decreases the anastomosis angle and therefore improves hemodynamics in the reconstruction, promotes laminar flow and improves hemodynamic parameters known to induce neointimal hyperplasia (Grus et al 2009, Grus et al 2016a, Grus et al 2016b.…”

Section: Discussionmentioning

confidence: 99%

“…Disturbed hemodynamics in the anastomosis especially too low or high wall shear stress has been identified to promote its formation (Grus et al 2009, Grus et al 2016a, Subbotin 2007. Based on clinical and simulation studies, several improvements addressing hemodynamics, including construction of an acute anastomosis angle, have been proposed (Bellosta et al 2013, Grus et al 2016a, Grus et al 2016b.…”

Section: Vol 67mentioning

confidence: 99%

Natural Remodeling of the Distal Anastomosis of an Above-Knee Femoropopliteal Bypass Depicted by CT Angiography of Lower Limbs Improves Geometry of the Reconstruction

Grusová

Lambert

Kaván³

et al. 2018

Physiol Res

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The geometry of the distal anastomosis of a femoropopliteal bypass influences local hemodynamics and formation of intimal hyperplasia. We hypothesized that the distal anastomosis of an above-knee femoropopliteal bypass undergoes remodeling that results in displacement of the original course of the popliteal artery and change in the anastomosis angle. We identified 43 CT angiography examination with proximal femoropopliteal bypass and either a preserved contralateral popliteal artery or previous CTA before construction of the bypass for comparison. In these examinations, we measured the displacement distance and angle at the level of the distal anastomosis and compared these measurements with clinical and imaging data. The displacement distance was 8.8±4.9 mm (P<0.0001) and the displacement angle was -1° (IQR=44°). The angle between the inflow and outflow artery was 153±16° (P<0.0001). There was a negative association between the displacement angle and the angle between the bypass and the outflow artery (r=-0.318, P=0.037).Patients with reversed venous grafts had a greater displacement of the anastomosis (14.7±3.0 mm) than patients with prosthetic grafts (8.0±4.5 mm, P=0.0011). We conclude that construction of a distal anastomosis of proximal femoropopliteal bypass results in displacement of the original course of the popliteal artery towards the bypass and this effect is more pronounced in reversed venous grafts.

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“…found to be beneficial and to entail near-physiological WSS. 17,18 We implemented the grafts as ideally straight tubes and assumed a perfect anastomosis with an oval orifice for all simulations. Three parameters were varied in the numerical simulations:…”

Section: Biomedical Engineering Societymentioning

confidence: 99%

Long-Term Venovenous Connection for Extracorporeal Carbon Dioxide Removal (ECCO2R)–Numerical Investigation of the Connection to the Common Iliac Veins

Steuer

Hugenroth

Beck

et al. 2020

Cardiovasc Eng Tech

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Purpose-Currently used cannulae for extracorporeal carbon dioxide removal (ECCO 2 R) are associated with complications such as thrombosis and distal limb ischemia, especially for long-term use. We hypothesize that the risk of these complications is reducible by attaching hemodynamically optimized grafts to the patient's vessels. In this study, as a first step towards a long-term stable ECCO 2 R connection, we investigated the feasibility of a venovenous connection to the common iliac veins. To ensure its applicability, the drainage of reinfused blood (recirculation) and high wall shear stress (WSS) must be avoided. Methods-A reference model was selected for computational fluid dynamics, on the basis of the analysis of imaging data. Initially, a sensitivity analysis regarding recirculation was conducted using as variables: blood flow, the distance of drainage and return to the iliocaval junction, as well as the diameter and position of the grafts. Subsequently, the connection was optimized regarding recirculation and the WSS was evaluated. We validated the simulations in a silicone model traversed by dyed fluid. Results-The simulations were in good agreement with the validation measurements (mean deviation 1.64%). The recirculation ranged from 32.1 to 0%. The maximum WSS did not exceed 5.57 Pa. The position and diameter of the return graft show the highest influence on recirculation. A correlation was ascertained between recirculation and WSS. Overall, an inflow jet directed at a vessel wall entails not only high WSS, but also a flow separation and thereby an increased recirculation. Therefore, return grafts aligned to the vena cava are crucial. Conclusion-In conclusion, a connection without recirculation could be feasible and therefore provides a promising option for a long-term ECCO 2 R connection.

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The Ratio of Diameters Between the Target Artery and the Bypass Modifies Hemodynamic Parameters Related to Intimal Hyperplasia in the Distal End-to-Side Anastomosis

Cited by 10 publications

References 27 publications

The effect of anagliptin on intimal hyperplasia of rat carotid artery after balloon injury

The effect of anagliptin on intimal hyperplasia of rat carotid artery after balloon injury

Natural Remodeling of the Distal Anastomosis of an Above-Knee Femoropopliteal Bypass Depicted by CT Angiography of Lower Limbs Improves Geometry of the Reconstruction

Long-Term Venovenous Connection for Extracorporeal Carbon Dioxide Removal (ECCO2R)–Numerical Investigation of the Connection to the Common Iliac Veins

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