Prophylactic gamma radiation of unaffected vein grafts failed to prevent vein graft disease in a chronic hypercholesterolemic porcine model.
OBJECTIVE
The value of prophylactic brachytherapy on vein graft disease is unknown.


RESULTS
Vein bypass grafts in 23 hypercholesterolemic pigs after ex vivo gamma irradiation of the vein grafts (10, 20, and 40Gy) and 16 control veins were analyzed regarding: (1) expression of platelet-derived growth factor (PDGF-AA and -BB, ELISA); (2) smooth muscle cell (SMC) proliferation/cell death (double-immunohistochemistry Mib-1/TUNEL/SMC alpha-actin); and (3) vessel wall dimensions. Planimetric data on vessel wall dimensions revealed no positive effect of gamma radiation on neointima formation and inner lumen diameter. On the contrary, vein grafts subjected to 40Gy were significantly more likely to be occluded and to have reduced inner lumen and increased neointima formation. Radiation therapy had no effect on PDGF expression and SMC proliferation/cell death. The mean inner lumen diameter decreased as PDGF-AA expression increased.


CONCLUSIONS
Prophylactic gamma radiation of unaffected vein grafts failed to prevent vein graft disease in a hypercholesterolemic porcine model. High-dose radiation (40Gy) resulted in more frequent graft occlusion and vein sclerosis.
Bartels
Claus
C
Clinic for Cardiac Surgery, Medical University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany. janfelixchristiansen@gmx.de
Erasmi
Armin
A
Sayk
Friedhelm
F
Eggers
Reinhard
R
Dendorfer
Andreas
A
Feyerabend
Thomas
T
Eichler
Wolfgang
W
Sievers
Hans-H
HH
D000714:Anastomosis, Surgical; D000818:Animals; D001918:Brachytherapy; D017536:Carotid Artery, Common / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002455:Cell Division; D002908:Chronic Disease; D004730:Endothelium, Vascular / Q000503:physiopathology; D005720:Gamma Rays; D006083:Graft Occlusion, Vascular / Q000473:pathology / Q000517:prevention & control*; D006937:Hypercholesterolemia / Q000378:metabolism / Q000532:radiotherapy / Q000601:surgery*; D007601:Jugular Veins / Q000473:pathology / Q000601:surgery*; D023421:Models, Animal; D009131:Muscle, Smooth, Vascular / Q000473:pathology / Q000528:radiation effects; D010982:Platelet-Derived Growth Factor / Q000378:metabolism; D020033:Protein Isoforms / Q000378:metabolism; D011879:Radiotherapy Dosage; D013194:Staining and Labeling; D013552:Swine
D010982:Platelet-Derived Growth Factor; D020033:Protein Isoforms