Use of Brilliant Blue FCF during vein graft preparation inhibits intimal hyperplasia

Abstract

Background Intimal hyperplasia remains the primary cause of vein graft failure for the 1 million yearly bypass procedures performed using human saphenous vein (HSV) grafts. This response to injury is caused in part by the harvest and preparation of the conduit. The use of Brilliant Blue FCF (FCF) restores injury-induced loss of function in vascular tissues possibly via inhibition of purinergic receptor signaling. This study investigated whether pretreatment of the vein graft with FCF prevents intimal hyperplasia. Methods Cultured rat aortic smooth muscle cells (A7r5) were used to determine the effect of FCF on platelet-derived growth factor-mediated migration and proliferation, cellular processes that contribute to intimal hyperplasia. The effectiveness of FCF treatment during the time of explantation on preventing intimal hyperplasia was evaluated in a rabbit jugular-carotid interposition model and in an organ culture model using HSV. Results FCF inhibited platelet-derived growth factor-induced migration and proliferation of A7r5 cells. Treatment with FCF at the time of vein graft explantation inhibited the subsequent development of intimal thickening in the rabbit model. Pretreatment with FCF also prevented intimal thickening of HSV in organ culture. Conclusions Incorporation of FCF as a component of vein graft preparation at the time of explantation represents a potential therapeutic approach to mitigate intimal hyperplasia, reduce vein graft failure, and improve outcome of the autologous transplantation of HSV.

Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft

“…7, 26 The addition of 50 μM brilliant blue FCF to Plasma-Lyte A improved endothelial-dependent relaxation in UP HSV and prevented intimal growth in HSV in an organ culture model and a rabbit model of vein grafting. 27 These beneficial effects of brilliant blue FCF, lack of cellular toxicity and distinct blue color make it attractive as an additive to an HSV preservation solution. 7 Our experiments were not sufficiently broad in scope to discern which additives in Celsior and University of Wisconsin solution most influenced graft performance.…”

Traditional graft preparation decreases physiologic responses, diminishes viscoelasticity, and reduces cellular viability of the conduit: A porcine saphenous vein model

“…49 Additionally, ex vivo treatment of rabbit external jugular conduit in a 50 μM solution of FCF in Plasma-Lyte A for one hour prior to implantation led to decreased neointimal growth in an in vivo carotid interposition model. 15 Taken together, these data suggest that current methods used to prepare human SV for transplantation into the coronary or peripheral circulation lead to significant damage to the conduit that may result in vein graft failure.…”

Standard Surgical Skin Markers Should Be Avoided for Intraoperative Vein Graft Marking during Cardiac and Peripheral Bypass Operations

“…While a significant increase in intimal thickness was noted among untreated veins, this was mitigated in the FCF-treated vein group ( 32 ). FCF, as a topical vein graft treatment in a rabbit external jugular–carotid artery interposition model, led to reduced neointimal growth relative to control grafts ( 34 ). Finally, platelet-derived growth factor-induced migration and proliferation were examined in A7r5 smooth muscle cells.…”

“…Finally, platelet-derived growth factor-induced migration and proliferation were examined in A7r5 smooth muscle cells. FCF pretreatment abrogated both cellular migration and proliferation ( 34 ).…”