Atherosclerosis in vascular grafts for peripheral vascular disease. Part 1. Autogenous vein grafts.
29 autogenous vein grafts, from 26 patients with peripheral arterial disease, were studied. 4 grafts of Group I (less than 3 months duration) were patent and removed for reasons other than graft failure. These showed 'arterialisation' only; 4 grafts of Group II (duration 5-18 months) showed thrombotic occlusion; 21 grafts of Group III (duration greater than 2 years) showed impaired graft patency and lipid identifiable as apolipoprotein B-containing-lipoproteins (LpB), and fibrinogen-related antigens (FRA) were seen as intramural deposits in the thickened grafts. LpB was also seen in a perifibrous distribution on the collagen of organised thrombi. Complicated lesions in some Group III grafts showed stenosis or occlusion, ulceration, calcification or aneurysm formation. These features suggest that a process indistinguishable from 'true' atherosclerosis affects vein grafts of long duration. The ways in which such changes may: contribute to graft failure; and improve our understanding of the basic processes involved in atherogenesis, are discussed.
D000328:Adult; D000368:Aged; D001055:Apolipoproteins B / Q000378:metabolism; D001158:Arteries; D001161:Arteriosclerosis / Q000473:pathology*; D004727:Endothelium / Q000473:pathology; D005260:Female; D005337:Fibrin / Q000378:metabolism; D006083:Graft Occlusion, Vascular / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014652:Vascular Diseases / Q000601:surgery*; D014680:Veins / Q000378:metabolism / Q000473:pathology / Q000637:transplantation*
D001055:Apolipoproteins B; D005337:Fibrin