The Role of Preexisting Pathology in the Development of Neointimal Hyperplasia in Coronary Artery Bypass Grafts

Kon, Zachary N.; White, Charles S.; Kwon, Michael H.; Judy, Jean; Brown, Emile N.; Gu, Jun; Burris, Nicholas S.; Laird, Patrick; Brown, Talitha; Brazio, Philip S.; Gammie, James S.; Brown, James M.; Griffith, Bartley P.; Poston, Robert

doi:10.1016/j.jss.2007.03.062

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…3). The histologic findings in the present study are similar to other studies that have evaluated saphenous veins harvested at the time of coronary artery bypass grafting (CABG) surgery (20–22). In their series of 46 saphenous vein segments and 27 internal mammary arteries, Friedl et al reported neointimal hyperplasia was present from 67% of veins vs. 29.6% of arteries (p<0.05) used in coronary artery bypass surgery (22).…”

Section: Discussionsupporting

confidence: 86%

“…Preexisting vascular changes prior to development of CKD may also be quite relevant. Studies that have evaluated saphenous veins used for CABG have also shown that higher baseline intimal–media thickness ratio was significantly associated with development of lumen loss over the first year after CABG (21). Thus, studies from CAD and our study suggest that vascular injuries to the vein occur prior to development of advanced CKD, and in CAD these vascular injuries may possibly negatively affect clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Natural History of Venous Morphologic Changes in Dialysis Access Stenosis

et al. 2014

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Natural History of Venous Morphologic Changes in Dialysis Access Stenosis

et al. 2014

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“…Th e degradation of extracellular matrix by MMPs, which provides a structural framework essential for the functional properties of vessel wall, was found to be a prerequisite for smooth muscle cells migration, a critical step in neointima formation [27]. Moreover, baseline level of MMP-2 in the saphenous vein wall was shown to have a strong linear correlation with the degree of luminal narrowing at 1 year aft er coronary artery bypass graft [32]. Perek et al (2016) stated that saphenous vein segments may be more appropriate graft s in the elderly population.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of blood vessels used for coronary artery bypass surgery

Garnizone

Vārtiņa

Pilmane

2019

PoA

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Saphenous veins are commonly used as coronary artery bypass grafts. Therefore, it is important to understand the vein wall morphology used for the bypass grafts. Methods. Ten specimens of saphenous veins were obtained from 10 patients admitted to the Heart Surgery Centre of P. Stradiņš Clinical University Hospital for coronary artery bypass surgery and a histopathological study was conducted. The slides were processed for histological routine and immunohistochemical staining with following markers: endothelin (ET), metallomembranoproteinase 2 (MMP2), tissue inhibitor of metalloproteinase 2 (TIMP2), transforming growth factor beta (TGF β), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), protein gene product 9.5 (PGP9.5), vascular cell adhesion molecule (VCAM), intercellular adhesion molecule (ICAM). For the analysis of the positive structures detected by immunohistochemistry, a semiquantitative evaluation method was used. Results. Normal histoarchitecture of the vein wall was evaluated by routine staining. Moderate positive endothelin containing endothelial cells and moderate to numerous positive VEGF cells were found on small blood vessels. Moderate positive MMP2 structures and variable – mainly moderate to numerous positive TIMP structures – were found in vein wall. Positive structures were evaluated as equal with both MMP2 and TIMP, with one exception where MMP2 positive structures were evaluated as moderate, but TIMP positive structures as few. All specimens were rich in TGFβ, VCAM and ICAM cells. Abundance of VCAM and ICAM positive endothelial cells was also found. Few HGF positive structures were found in tunica intima and few PGP9.5 positive nerve fibres in tunica adventitia. Conclusions. Rich expression of TGFβ, VCAM, ICAM is characteristic for saphenous vein. A number of VEGF, MMP and TIMP positive cells found in saphenous vein wall indicates a presence of tissue remodelling and ischemia, while low number of HGF positive cells shows its lesser involvement in homeostasis regulation.

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“…The degradation of ECM by MMPs, which provides a structural framework essential for the functional properties of vessel wall, was found to be a prerequisite for SMCs migration, a critical step in neointima formation [4]. Moreover, baseline level of MMP-2 in the SV wall was shown to have a strong linear correlation with the degree of luminal narrowing at 1 year after CABG [17]. Our finding of an association between MMP-2 expression and degree of differentiation of the venous SMCs in the tunica media supports the observations of Xiao et al who showed a negative association between production of MMP-2 and degree of differentiation of the medial SMCs in the SV segments derived from varicose veins [15].…”

Section: Discussionmentioning

confidence: 99%

Potentially positive ageing-related variations of medial smooth muscle cells in the saphenous veins used as aortocoronary bypass grafts

Perek

Malińska

Gąsowski

et al. 2015

Folia Histochem Cytobiol.

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Introduction. Currently, elderly people constitute a large proportion of patients undergoing coronary artery bypass grafting (CABG). Activated smooth muscle cells in the tunica media of saphenous vein (SV) grafts are thought to play a key role in the formation of neointima and development of occluding atherosclerotic plaques. The aim of this study was to identify ageing-related variations in the expression of the smooth muscle cells proteins that may impact on patency rate of the grafts and the CABG outcomes. Material and methods. The study involved 216 consecutive patients with the mean of 62.7 ± 8.4 years who underwent isolated CABG with at least one SV aortocoronary bypass graft. Expression of a-smooth muscle actin (a-SM actin), smooth muscle-myosin heavy chain (SM-MHC), calponin (CALP), cytokeratin 8 (CK-8), metalloproteinase-2 (MMP-2) and tissue inhibitors of metalloproteinases-2 and -3 (TIMP-2, TIMP-3) in the SV wall was assessed by immunohistochemistry and correlated with the age of patients. Results. Calponin and a-SM actin were expressed in all studied SV transplants. SM-MHC immunoreactivity was observed in SV segments in 68.5% of patients, whereas MMP-2a and TIMPs expression was found in 75% of cases. In more than 50% of analyzed SV transplants, no expression of cytokeratin-8 was found. Moderate correlations between preexisting expressions of either cytoskeletal or hemostatic proteins in the tunica media of the SV grafts and the age of CABG patients were demonstrated. They were positive for SM-MHC (r = 0.494), CALP (r = 0.548), TIMP-2 (r = 0.413) and TIMP-3 (r = 0.406) whereas negative for CK-8 (r = -0.528) and MMP-2 (r = -0.417). Conclusions. Age-dependent decreases in the expression of MMP-2 and CK-8 accompanied by increases in expression of SM-MHC, TIMP-2 and TIMP-3 may promote SV graft patency and, thus, suggest a rationale for common use of SV grafts in the elderly.

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The Role of Preexisting Pathology in the Development of Neointimal Hyperplasia in Coronary Artery Bypass Grafts

Cited by 9 publications

References 22 publications

Natural History of Venous Morphologic Changes in Dialysis Access Stenosis

Natural History of Venous Morphologic Changes in Dialysis Access Stenosis

Characterisation of blood vessels used for coronary artery bypass surgery

Potentially positive ageing-related variations of medial smooth muscle cells in the saphenous veins used as aortocoronary bypass grafts

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