Biogenesis and etiology of distal anastomotic intimal hyperplasia.
Distal anastomotic intimal hyperplasia (DAIH) is a viable biologic entity composed of a multi-interlamination of cells and extracellular matrix. Cell transformation and orientation characterize the dynamic process of this 80-130 cell structure. Morphologic similarity exists in the cytoarchitecture of DAIH irrespective of the graft material. Compliance mismatch is not a cause of DAIH, but it enhances the formation. The geometry of the unnatural distal end-to-side anastomosis is predisposed to turbulent flow and DAIH formation. Prevention of DAIH is dependent on pharmacologic suppression of subendothelial smooth muscle proliferation and synthesis of extracellular matrix.
Sottiurai
V S
VS
Louisiana State University School of Medicine, Department of Surgery, New Orleans 70112-2822.
D000818:Animals; D001158:Arteries / Q000473:pathology; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001807:Blood Vessel Prosthesis; D004285:Dogs; D004730:Endothelium, Vascular / Q000473:pathology; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D008854:Microscopy, Electron; D009131:Muscle, Smooth, Vascular / Q000473:pathology*; D011138:Polytetrafluoroethylene; D013997:Time Factors
D011138:Polytetrafluoroethylene