Compliance mismatch and formation of distal anastomotic intimal hyperplasia in externally stiffened and lumen-adapted venous grafts.
OBJECTIVE
Compliance and formation of distal anastomotic intimal hyperplasia (DAIH) were investigated in externally stiffened venous grafts of varying calibers.


METHODS
36 femoropopliteal reconstructions were performed in 18 sheep. The autologous venous grafts were inserted into tubes made of Dacron mesh to achieve compliance-mismatch and lumen adaptation. Compliance was measured by echotracked ultrasonography and profiles of DAIH were generated from histologic sections harvested after 8.3 months.


RESULTS
The external mesh tube significantly lowered the local compliance of graft and host artery. DAIH appeared extensively in those groups where mesh tube constricted venous grafts met untreated host arteries (p = 0.002). No differences in compliance and DAIH formation were observed when grafts with large and adapted diameters were compared.


CONCLUSIONS
For prevention of DAIH the distal venous graft diameter is not important, while the local compliance of an autologous vein is a predictive factor for DAIH formation and thus long-term patency.
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001794:Blood Pressure; D003187:Compliance; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000473:pathology* / Q000637:transplantation*; D005500:Follow-Up Studies; D005544:Forecasting; D006965:Hyperplasia; D011093:Polyethylene Terephthalates; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012039:Regional Blood Flow; D012756:Sheep; D013499:Surface Properties; D013526:Surgical Mesh; D014182:Transplantation, Autologous; D017539:Tunica Intima / Q000473:pathology*; D014463:Ultrasonography; D014654:Vascular Patency
D011093:Polyethylene Terephthalates