Can nonpenetrating vascular closure staples and hepatocyte growth factor prevent intimal hyperplasia following ePTFE grafting of the carotid artery in rabbits?
OBJECTIVE
To evaluate whether nonpenetrating vascular closure staples (VCS) and hepatocyte growth factor (HGF) can effectively prevent anastomotic intimal hyperplasia.


METHODS
An expanded polytetrafluoroethylene graft, 2 mm in diameter, was implanted in the common carotid artery of rabbits divided into three experimental groups. In the control group, distal anastomosis was performed with interrupted suturing; in the VCS group, clips were applied along the lateral suture line after the placement of stay sutures; and in the VCS + HGF group, the same anastomotic technique was performed as in the VCS group, followed by the administration of the HGF for 4 days.


RESULTS
The time taken to complete the anastomosis was significantly less in both the VCS groups than in the control group ( P < 0.0001). On postoperative day (POD) 28, the patency rate was significantly lower ( P < 0.05) in the VCS group (42.9%) than in the control group (100%), but the rate in the VCS + HGF group (100%) was the same as that in the control group. Intimal thickness was significantly less in the control group than in either the VCS or VCS + HGF groups ( P< 0.05). The percentage of area stenosis was significantly less ( P< 0.01) in the control group than in the VCS group.


CONCLUSIONS
The VCS clip failed to suppress intimal thickness or reduce the percentage of stenosis at the anastomotic site.
Akita
Masafumi
M
First Department of Surgery, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
Takenaka
Hiroaki
H
Harada
Masakazu
M
Li
Tao-Sheng
TS
Zhang
Hua
H
Zempo
Nobuya
N
Esato
Kensuke
K
Nagano
Tomokazu
T
Taiji
Mutsuo
M
Noguchi
Hiroshi
H
D000714:Anastomosis, Surgical; D000818:Animals; D019917:Blood Vessel Prosthesis Implantation; D002339:Carotid Arteries / Q000601:surgery; D003251:Constriction, Pathologic / Q000517:prevention & control; D005549:Foreign-Body Reaction / Q000517:prevention & control*; D017228:Hepatocyte Growth Factor / Q000008:administration & dosage / Q000494:pharmacology*; D006965:Hyperplasia; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D013536:Suture Techniques; D013537:Sutures; D017539:Tunica Intima / Q000473:pathology*
D017228:Hepatocyte Growth Factor; D011138:Polytetrafluoroethylene