title: Use of arterial patch to improve re-endothelialization in a sheep model of open carotid endarterectomy. An incentive to use internal thoracic artery as an on-lay patch following coronary endarterecomy?
abstract: To better understand the effect of the internal thoracic artery on endothelial growth after open coronary endarterectomy, we designed an experimental test of the hypothesis that closing an endarterectomized artery by an arterial patch improves re-endothelialization. The two carotid arteries were endarterectomized in nine sheep and were randomly chosen for closure by native arterial femoral (ART) patch or polytetrafluoroethylene (PTFE) patch. Three animals were randomly chosen for sacrifice at 8, 15 and 21 days each. The endarterectomized segments were studied macroscopically and microscopically. The endarterectomized area covered with adhesive thrombus was more extensive in the PTFE than in the ART group (P=0.0117). In the ART group, the regenerated endothelium was normal and sprouted from the edges of both the endarterectomy and the arterial patch towards the central endarterectomized area. In the PTFE group, it sprouted from the edges of the endarterectomy and never reached the central endarterectomized area, where abnormal endothelium was observed. The endarterectomized area covered with normal endothelium was more extensive in the ART than in the PTFE group at 8 days, at 15 days, and 21 days (P<0.001). Arterial patch closure of open-endarterectomized artery improved regenerated endothelium quality.
authors.affiliation: Department of Cardio-vascular and Thoracic Surgery, University Hospital La Cavale Blanche, Brest, France. eric.bezon@chu-brest.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Bezon
authors.forename: Ahmed Aziz
authors.initials: AA
authors.lastname: Khalifa
authors.forename: Grégoire
authors.initials: G
authors.lastname: Le Gal
authors.forename: Jean Noël
authors.initials: JN
authors.lastname: Choplain
authors.forename: Jacques
authors.initials: J
authors.lastname: Mansourati
authors.forename: Jean Auber
authors.initials: JA
authors.lastname: Barra
mesh_terms: D000818:Animals; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002339:Carotid Arteries / Q000601:surgery* / Q000648:ultrastructure; D049109:Cell Proliferation; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000295:instrumentation / Q000379:methods*; D004730:Endothelium, Vascular / Q000601:surgery* / Q000648:ultrastructure; D005263:Femoral Artery / Q000637:transplantation*; D008323:Mammary Arteries / Q000637:transplantation*; D023421:Models, Animal; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012756:Sheep; D013536:Suture Techniques; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D011138:Polytetrafluoroethylene