The use of the gastroepiploic artery for peripheral revascularisation. A study in pigs.
OBJECTIVE
To use the autologous gastroepiploic artery (GEA) as arterial bypass graft for peripheral revascularisation. We compared the development of intimal hyperplasia and nitric oxide (NO) capacity in GEA and internal jugular vein (IJV) implanted as peripheral grafts.


METHODS
In pigs the GEA was implanted into the right peripheral circulation as a femoropopliteal bypass graft. In the left peripheral circulation the IJV was implanted as a femoropopliteal graft. After 21 days all grafts were harvested. Vascular rings of each graft before and after operation were studied for NO capacity. The distal half of each graft was prepared for histomorphometric studies.


RESULTS
Administration of bradykinin to IJV and GEA induced relaxation. After implantation bradykinin resulted in contraction in IJV grafts, whereas in GEA grafts relaxation was reduced. In IJV grafts extensive intimal hyperplasia was formed, whereas in GEA grafts only small areas of intimal hyperplasia were formed.


CONCLUSIONS
The functional studies lost NO capacity in IJV grafts, whereas NO capacity in GEA grafts remained intact. Intimal hyperplasia in IJV grafts was extensive, whereas GEA grafts demonstrated preservation of pre-existent intimal architecture. These results may encourage the application of the human GEA as bypass graft for reconstruction of arteries in the lower limb or foot.
Toes
G J
GJ
Department of Surgery, University Hospital Groningen, The Netherlands.
van Geel
P P
PP
van den Dungen
J J
JJ
Buikema
H
H
Grandjean
J G
JG
Verhoeven
E L
EL
van Oeveren
W
W
Timens
W
W
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001158:Arteries / Q000378:metabolism / Q000473:pathology / Q000637:transplantation*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006965:Hyperplasia / Q000473:pathology; D007601:Jugular Veins / Q000378:metabolism / Q000473:pathology / Q000637:transplantation; D009569:Nitric Oxide / Q000378:metabolism; D011150:Popliteal Artery / Q000601:surgery*; D013552:Swine; D014182:Transplantation, Autologous; D014654:Vascular Patency; D014656:Vascular Surgical Procedures
D009569:Nitric Oxide