Increased Blood Flow Inhibits Neointimal Hyperplasia in Endothelialized Vascular Grafts
Intimal hyperplasia is a primary cause of failure after vascular reconstruction and may be affected by blood flow. We have studied the effects of increased blood flow on intimal hyperplasia in porous polytetrafluoroethylene grafts implanted in baboons. These grafts develop an endothelial lining by 2...
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| Veröffentlicht in: | Circulation research 1991-12, Vol.69 (6), p.1557-1565 |
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| container_title | Circulation research |
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| creator | Kohler, Ted R Kirkman, Thomas R Kraiss, Larry W Zierler, Brenda K Clowes, Alexander W |
| description | Intimal hyperplasia is a primary cause of failure after vascular reconstruction and may be affected by blood flow. We have studied the effects of increased blood flow on intimal hyperplasia in porous polytetrafluoroethylene grafts implanted in baboons. These grafts develop an endothelial lining by 2 weeks and neointimal thickening due to proliferation of underlying smooth muscle cells by 1 month. Creation of a distal arteriovenous fistula increased flow (from 230±35 to 785±101 ml/min, p |
| doi_str_mv | 10.1161/01.res.69.6.1557 |
| format | Article |
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We have studied the effects of increased blood flow on intimal hyperplasia in porous polytetrafluoroethylene grafts implanted in baboons. These grafts develop an endothelial lining by 2 weeks and neointimal thickening due to proliferation of underlying smooth muscle cells by 1 month. Creation of a distal arteriovenous fistula increased flow (from 230±35 to 785±101 ml/min, p <0.001) and mean shear (from 26±4 to 78±10 dynes/cm, p <0.001) without causing a drop in pressure across the grafts. Fistula flow did not alter the pattern of endothelial coverage but did cause a marked reduction in the cross-sectional area of the neointima (from 2.60±0.52 to 0.42±0.07 mm at 3 months, p <0.01). Detailed morphometric analysis revealed an equivalent percentage decrease in smooth muscle cells and matrix content, suggesting that the primary effect of increased flow was to reduce smooth muscle cell number without affecting the amount of matrix produced by individual cells. The neointima remained sensitive to changes in flow at late times; ligation of the fistula after 2 months resulted in a rapid increase in neointimal thickness (from 0.60±0.03 mm after 2 months of fistula flow to 3.88±0.55 mm 1 month after ligation of fistula, p <0.01). These results support the hypothesis that changes in blood flow affect the structure of diseased as well as normal vessels.</description><identifier>ISSN: 0009-7330</identifier><identifier>EISSN: 1524-4571</identifier><identifier>DOI: 10.1161/01.res.69.6.1557</identifier><identifier>PMID: 1954675</identifier><identifier>CODEN: CIRUAL</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>Animals ; Biological and medical sciences ; Blood Flow Velocity ; Blood Vessel Prosthesis ; Endothelium, Vascular - pathology ; Hemodynamics ; Hyperplasia ; Male ; Medical sciences ; Muscle, Smooth, Vascular - pathology ; Papio ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Vascular Patency ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>Circulation research, 1991-12, Vol.69 (6), p.1557-1565</ispartof><rights>1991 American Heart Association, Inc.</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5133-4e32c1f2cf8566dbc2faaf7d531bce387a7584ce104e5b7443073d8ce5f0c3483</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3685,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5075954$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1954675$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kohler, Ted R</creatorcontrib><creatorcontrib>Kirkman, Thomas R</creatorcontrib><creatorcontrib>Kraiss, Larry W</creatorcontrib><creatorcontrib>Zierler, Brenda K</creatorcontrib><creatorcontrib>Clowes, Alexander W</creatorcontrib><title>Increased Blood Flow Inhibits Neointimal Hyperplasia in Endothelialized Vascular Grafts</title><title>Circulation research</title><addtitle>Circ Res</addtitle><description>Intimal hyperplasia is a primary cause of failure after vascular reconstruction and may be affected by blood flow. We have studied the effects of increased blood flow on intimal hyperplasia in porous polytetrafluoroethylene grafts implanted in baboons. These grafts develop an endothelial lining by 2 weeks and neointimal thickening due to proliferation of underlying smooth muscle cells by 1 month. Creation of a distal arteriovenous fistula increased flow (from 230±35 to 785±101 ml/min, p <0.001) and mean shear (from 26±4 to 78±10 dynes/cm, p <0.001) without causing a drop in pressure across the grafts. Fistula flow did not alter the pattern of endothelial coverage but did cause a marked reduction in the cross-sectional area of the neointima (from 2.60±0.52 to 0.42±0.07 mm at 3 months, p <0.01). Detailed morphometric analysis revealed an equivalent percentage decrease in smooth muscle cells and matrix content, suggesting that the primary effect of increased flow was to reduce smooth muscle cell number without affecting the amount of matrix produced by individual cells. The neointima remained sensitive to changes in flow at late times; ligation of the fistula after 2 months resulted in a rapid increase in neointimal thickness (from 0.60±0.03 mm after 2 months of fistula flow to 3.88±0.55 mm 1 month after ligation of fistula, p <0.01). These results support the hypothesis that changes in blood flow affect the structure of diseased as well as normal vessels.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Blood Vessel Prosthesis</subject><subject>Endothelium, Vascular - pathology</subject><subject>Hemodynamics</subject><subject>Hyperplasia</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Muscle, Smooth, Vascular - pathology</subject><subject>Papio</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Vascular Patency</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><issn>0009-7330</issn><issn>1524-4571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkU1v1DAQhi0EKkvLnQtSDqi3BE_8lRyh2rYrVSBBW46W44y1Bm-82IlW5dfjaldwGI1G87yjmXcIeQe0AZDwkUKTMDeyb2QDQqgXZAWi5TUXCl6SFaW0rxVj9DV5k_NPSoGztj8jZ9ALLpVYkR-bySY0Gcfqc4hxrK5DPFSbaesHP-fqC0Y_zX5nQnX7tMe0DyZ7U_mpWk9jnLcYvAn-T1E_mmyXYFJ1k4yb8wV55UzI-PaUz8nD9fr-6ra--3qzufp0V1sBjNUcWWvBtdZ1QspxsK0zxqlRMBgssk4ZJTpuEShHMSjOGVVs7CwKRy3jHTsnl8e5-xR_L5hnvfPZYghmwrhkrVre9T3IAtIjaFPMOaHT-1TuSk8aqH72UlPQ39bftey11M9eFsn70-xl2OH4X3A0r_Q_nPrldhNcMpP1-R8mqBKFLBg_YocYZkz5V1gOmPQWTZi3uryIMgptDWVNaEtVlyje_AUZKIyK</recordid><startdate>199112</startdate><enddate>199112</enddate><creator>Kohler, Ted R</creator><creator>Kirkman, Thomas R</creator><creator>Kraiss, Larry W</creator><creator>Zierler, Brenda K</creator><creator>Clowes, Alexander W</creator><general>American Heart Association, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199112</creationdate><title>Increased Blood Flow Inhibits Neointimal Hyperplasia in Endothelialized Vascular Grafts</title><author>Kohler, Ted R ; Kirkman, Thomas R ; Kraiss, Larry W ; Zierler, Brenda K ; Clowes, Alexander W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5133-4e32c1f2cf8566dbc2faaf7d531bce387a7584ce104e5b7443073d8ce5f0c3483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Blood Vessel Prosthesis</topic><topic>Endothelium, Vascular - pathology</topic><topic>Hemodynamics</topic><topic>Hyperplasia</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Muscle, Smooth, Vascular - pathology</topic><topic>Papio</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Vascular Patency</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kohler, Ted R</creatorcontrib><creatorcontrib>Kirkman, Thomas R</creatorcontrib><creatorcontrib>Kraiss, Larry W</creatorcontrib><creatorcontrib>Zierler, Brenda K</creatorcontrib><creatorcontrib>Clowes, Alexander W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kohler, Ted R</au><au>Kirkman, Thomas R</au><au>Kraiss, Larry W</au><au>Zierler, Brenda K</au><au>Clowes, Alexander W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased Blood Flow Inhibits Neointimal Hyperplasia in Endothelialized Vascular Grafts</atitle><jtitle>Circulation research</jtitle><addtitle>Circ Res</addtitle><date>1991-12</date><risdate>1991</risdate><volume>69</volume><issue>6</issue><spage>1557</spage><epage>1565</epage><pages>1557-1565</pages><issn>0009-7330</issn><eissn>1524-4571</eissn><coden>CIRUAL</coden><abstract>Intimal hyperplasia is a primary cause of failure after vascular reconstruction and may be affected by blood flow. We have studied the effects of increased blood flow on intimal hyperplasia in porous polytetrafluoroethylene grafts implanted in baboons. These grafts develop an endothelial lining by 2 weeks and neointimal thickening due to proliferation of underlying smooth muscle cells by 1 month. Creation of a distal arteriovenous fistula increased flow (from 230±35 to 785±101 ml/min, p <0.001) and mean shear (from 26±4 to 78±10 dynes/cm, p <0.001) without causing a drop in pressure across the grafts. Fistula flow did not alter the pattern of endothelial coverage but did cause a marked reduction in the cross-sectional area of the neointima (from 2.60±0.52 to 0.42±0.07 mm at 3 months, p <0.01). Detailed morphometric analysis revealed an equivalent percentage decrease in smooth muscle cells and matrix content, suggesting that the primary effect of increased flow was to reduce smooth muscle cell number without affecting the amount of matrix produced by individual cells. The neointima remained sensitive to changes in flow at late times; ligation of the fistula after 2 months resulted in a rapid increase in neointimal thickness (from 0.60±0.03 mm after 2 months of fistula flow to 3.88±0.55 mm 1 month after ligation of fistula, p <0.01). These results support the hypothesis that changes in blood flow affect the structure of diseased as well as normal vessels.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>1954675</pmid><doi>10.1161/01.res.69.6.1557</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Ovid Autoload |
| subjects | Animals Biological and medical sciences Blood Flow Velocity Blood Vessel Prosthesis Endothelium, Vascular - pathology Hemodynamics Hyperplasia Male Medical sciences Muscle, Smooth, Vascular - pathology Papio Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Vascular Patency Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
| title | Increased Blood Flow Inhibits Neointimal Hyperplasia in Endothelialized Vascular Grafts |
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