Extravascular perivenous fibrin support leads to aneurysmal degeneration and intimal hyperplasia in arterialized vein grafts in the rat.
OBJECTIVE
External support of vein grafts by fibrin glue possibly prevents overdistension, vascular remodeling, and neointimal hyperplasia. Previous animal models of neointimal hyperplasia showed conflicting results. Here, long-term effects of external fibrin glue support were studied in a new rat model of jugular vein to abdominal aorta transposition. MATERIALS AND METHODS AND METHODS: In male Wistar rats (250-300 g) right jugular vein (1.0-1.5 cm) was transposed to the infrarenal aorta. Fibrin glue (0.25 ml) covered the vein before releasing the vascular clamps (n = 6). Control vein grafts were exposed directly to blood pressure. After 16 weeks vein grafts were pressure-fixed for histology. Intima thickness, luminal and intimal area were measured by planimetry and elastic fibers demonstrated by Elastica van Giesson staining.


RESULTS
Intimal thickness (74.04 +/- 6.7 microm vs 1245 +/- 187 microm, control vs fibrin treatment; p < 0.001), intimal area (2517.16 +/- 355 mm(2) vs 18424 +/- 4927 mm(2), control vs fibrin treatment; p < 0.05) and luminal area (2184.75 +/- 347 mm(2) vs 7231.85 +/- 1782 mm(2), control vs fibrin treatment; p < 0.05) were significantly increased, elastic fibers in the vessel wall were diminished and the vessel wall infiltrated by mononuclear cells in fibrin glue supported veins.


CONCLUSIONS
External support of vein grafts by fibrin glue leads to aneurysmal degeneration and intimal hyperplasia, thereby possibly jeopardizing long-term graft patency.
Department of Cardiothoracic and Vascular Surgery, Universitätsmedizin Göttingen, Göttingen, Germany. tstojan@gwdg.de
Tomislav
T
Stojanovic
Ali
A
El-Sayed Ahmad
Vasilios
V
Didilis
Osama
O
Ali
Aron F
AF
Popov
Bernd C
BC
Danner
Ralf
R
Seipelt
Hilmar
H
Dörge
Friedrich A
FA
Schöndube
D000818:Animals; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000139:chemically induced* / Q000473:pathology; D004547:Elastic Tissue / Q000473:pathology; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000139:chemically induced / Q000473:pathology; D006965:Hyperplasia; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D017539:Tunica Intima / Q000187:drug effects* / Q000473:pathology*; D014680:Veins / Q000473:pathology / Q000637:transplantation*
D015718:Fibrin Tissue Adhesive