Pre-bypass morphological changes in vein grafts.
Random vein samples taken prior to bypass surgery have shown certain pathological features. Long saphenous vein was taken from the groin (proximal) and knee to mid-calf (distal) of 85 patients undergoing femoro-distal bypass over a 2-year period. During this period only four patients had cephalic arm vein used; this was also studied. Histological examination was performed using haematoxylin and eosin and van Geison stains. Intimal hyperplasia was seen in 62 (73%) proximal and 74 (87%) distal samples. There were significantly more distal veins with moderate to severe focal hyperplasia and circular muscle hypertrophy (p < 0.05 and p < 0.001). Changes of diffuse intimal hyperplasia were seen in three of the cephalic veins. Muscle hypertrophy occurred in 58 (68%) of proximal segments compared to 75 (88%) of distal segments (p < 0.005). This study shows that significant pathological changes are seen in long saphenous and cephalic veins thought to be "normal". These changes are more evident in the distal long saphenous vein. These changes may have a significant effect on the outcome of vein bypass.
Davies
A H
AH
Department of Vascular Studies and Histopathology, Bristol Royal Infirmary, U.K.
Magee
T R
TR
Baird
R N
RN
Sheffield
E
E
Horrocks
M
M
D000368:Aged; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D006984:Hypertrophy / Q000473:pathology; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000473:pathology*; D012501:Saphenous Vein / Q000473:pathology* / Q000637:transplantation*; D017539:Tunica Intima / Q000473:pathology*