[Localized intimal hyperplasia in autologous vein graft: does presence of the valve induce obliteration?].
The present study was undertaken to examine the role of venous valve in the development of focal intimal hyperplasia (IH) occurring in autologous vein graft. The jugular vein of Japanese white rabbit containing a valve, was implanted to the carotid artery. Four weeks after the operation, histological, morphometrical and immunohistochemical [using bromodeoxyuridine (BrdU)] studies were performed on the grafted vein. The contralateral jugular vein served as control. The control vein revealed marked discontinuity of internal elastic lamina (IEL) of valve sinus (VS), as compared with non-valvular region (NVR). IH developed in both VS and NVR of the grafted vein, but there was a significant difference between them. The features of IH of VS were as follows; 1) marked thickening (269 +/- 137 microns, VS; 84 +/- 25 microns, NVR P < 0.01), 2) neovascular formation (73%), some of which were accompanied by intimal hemorrhage, 3) significantly higher BrdU labeling index (3.1 +/- 2.4%, VS; 1.1 +/- 0.3%, NVR P < 0.01). These data strongly suggest that IH of VS is responsible for focal IH, and it leads to obliteration of the graft. In that process, the discontinuity of the IEL plays a paramount role in the pathogenesis of focal IH.
Ohki
T
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First Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
D000818:Animals; D002339:Carotid Arteries / Q000601:surgery; D002455:Cell Division; D004547:Elastic Tissue / Q000502:physiology; D006965:Hyperplasia; D007601:Jugular Veins / Q000166:cytology / Q000473:pathology* / Q000637:transplantation*; D009389:Neovascularization, Pathologic; D011817:Rabbits