Non-penetrating vascular clips anastomosis inhibited intimal thickening under poor runoff conditions in canine autogenous vein grafts

K. Komori, T. Shoji, T. Furuyama, Y. Yonemitsu, E. Mori, T. Yamaoka, T. Matsumoto, K. Sugimachi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: Late graft failure is still a significant problem, particularly in cases with poor runoff vessels. The main cause of late graft failure is intimal thickening of the anastomotic region. Vascular closure system (VCS) clips may provide ideal anastomosis, since they do not penetrate the wall. Therefore, we examined whether the VCS clips affect intimal thickening under poor runoff conditions in the canine autogenous vein grafts. Methods: A canine poor runoff model was prepared at both femoral veins. Four weeks after the first surgical procedure, two groups were established according to the two different methods of anastomosis employed. The right femoral vein graft was performed using polypropylene sutures, conventional surgical anastomosis (control group), while the left femoral vein graft was performed using VCS clips anastomosis (VCS group). Four weeks after grafting, the vein grafts were removed and the intimal thickening of proximal, distal anastomosis and midportion of the vein grafts were examined histologically. Results: In the control group, flow rate and variation were 26 ± 8 ml/min and 51 ± 10 dynes/cm2, respectively. In the VCS group, the flow rate and variation were 23 ± 11 ml/min and 44 ± 14 dynes/cm2, respectively. There were no significant differences between the two groups. The average value of intimal thickening of both the anastomotic region and the midportion of the vein graft in the VCS group was significantly inhibited compared to that of the control group. The number of positive cells of masson trichrome stain in the VCS group was significantly less than that of the control group. Conclusions: These experiments indicate that VCS clips significantly inhibit intimal thickening under poor runoff conditions in canine autogenous vein grafts to a greater extent compared to suture-constructed anastomosis. One mechanism that may account for the decreased intimal thickening is the inhibition of the expression of transforming growth factor-β (TGF-β), because the number of positive cells of masson trichrome stain in the VCS group was significantly less than that of the control group.

Original languageEnglish
Pages (from-to)241-247
Number of pages7
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume21
Issue number3
DOIs
Publication statusPublished - Jan 1 2001

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Tunica Intima
Surgical Instruments
Blood Vessels
Canidae
Veins
Transplants
Femoral Vein
Control Groups
Sutures
Surgical Anastomosis
Cell Count
Polypropylenes
Transforming Growth Factors

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

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Non-penetrating vascular clips anastomosis inhibited intimal thickening under poor runoff conditions in canine autogenous vein grafts. / Komori, K.; Shoji, T.; Furuyama, T.; Yonemitsu, Y.; Mori, E.; Yamaoka, T.; Matsumoto, T.; Sugimachi, K.

In: European Journal of Vascular and Endovascular Surgery, Vol. 21, No. 3, 01.01.2001, p. 241-247.

Research output: Contribution to journalArticle

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abstract = "Objective: Late graft failure is still a significant problem, particularly in cases with poor runoff vessels. The main cause of late graft failure is intimal thickening of the anastomotic region. Vascular closure system (VCS) clips may provide ideal anastomosis, since they do not penetrate the wall. Therefore, we examined whether the VCS clips affect intimal thickening under poor runoff conditions in the canine autogenous vein grafts. Methods: A canine poor runoff model was prepared at both femoral veins. Four weeks after the first surgical procedure, two groups were established according to the two different methods of anastomosis employed. The right femoral vein graft was performed using polypropylene sutures, conventional surgical anastomosis (control group), while the left femoral vein graft was performed using VCS clips anastomosis (VCS group). Four weeks after grafting, the vein grafts were removed and the intimal thickening of proximal, distal anastomosis and midportion of the vein grafts were examined histologically. Results: In the control group, flow rate and variation were 26 ± 8 ml/min and 51 ± 10 dynes/cm2, respectively. In the VCS group, the flow rate and variation were 23 ± 11 ml/min and 44 ± 14 dynes/cm2, respectively. There were no significant differences between the two groups. The average value of intimal thickening of both the anastomotic region and the midportion of the vein graft in the VCS group was significantly inhibited compared to that of the control group. The number of positive cells of masson trichrome stain in the VCS group was significantly less than that of the control group. Conclusions: These experiments indicate that VCS clips significantly inhibit intimal thickening under poor runoff conditions in canine autogenous vein grafts to a greater extent compared to suture-constructed anastomosis. One mechanism that may account for the decreased intimal thickening is the inhibition of the expression of transforming growth factor-β (TGF-β), because the number of positive cells of masson trichrome stain in the VCS group was significantly less than that of the control group.",
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AU - Komori, K.

AU - Shoji, T.

AU - Furuyama, T.

AU - Yonemitsu, Y.

AU - Mori, E.

AU - Yamaoka, T.

AU - Matsumoto, T.

AU - Sugimachi, K.

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AB - Objective: Late graft failure is still a significant problem, particularly in cases with poor runoff vessels. The main cause of late graft failure is intimal thickening of the anastomotic region. Vascular closure system (VCS) clips may provide ideal anastomosis, since they do not penetrate the wall. Therefore, we examined whether the VCS clips affect intimal thickening under poor runoff conditions in the canine autogenous vein grafts. Methods: A canine poor runoff model was prepared at both femoral veins. Four weeks after the first surgical procedure, two groups were established according to the two different methods of anastomosis employed. The right femoral vein graft was performed using polypropylene sutures, conventional surgical anastomosis (control group), while the left femoral vein graft was performed using VCS clips anastomosis (VCS group). Four weeks after grafting, the vein grafts were removed and the intimal thickening of proximal, distal anastomosis and midportion of the vein grafts were examined histologically. Results: In the control group, flow rate and variation were 26 ± 8 ml/min and 51 ± 10 dynes/cm2, respectively. In the VCS group, the flow rate and variation were 23 ± 11 ml/min and 44 ± 14 dynes/cm2, respectively. There were no significant differences between the two groups. The average value of intimal thickening of both the anastomotic region and the midportion of the vein graft in the VCS group was significantly inhibited compared to that of the control group. The number of positive cells of masson trichrome stain in the VCS group was significantly less than that of the control group. Conclusions: These experiments indicate that VCS clips significantly inhibit intimal thickening under poor runoff conditions in canine autogenous vein grafts to a greater extent compared to suture-constructed anastomosis. One mechanism that may account for the decreased intimal thickening is the inhibition of the expression of transforming growth factor-β (TGF-β), because the number of positive cells of masson trichrome stain in the VCS group was significantly less than that of the control group.

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