Intensive statin therapy: a favorable adjunct to the improvement of small-diameter vascular grafts.
To assess the effect of intensive statins therapy on the outcome of small-diameter vascular prosthesis, we investigated whether atorvastatin treatment (30 mg/d) could accelerate the re-endothelialization process and improve the patency rate in a canine infrarenal abdominal aorta-expanded polytetrafluoroethylene (ePTFE) bypass model. Furthermore, we also evaluated the effect of atorvastatin on the migratory and adherent capacity of circulating endothelial progenitor cells (EPCs) in vitro. Improved patency was confirmed by Doppler sonography and arteriography. Histological and scanning electron microscopy illustrated enhanced re-endothelialization process. Treatment with atorvastatin enhanced the circulating pool of EPCs with fortified migratory and adherent capacity. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed that atorvastatin treatment increased endothelial nitric oxide synthase (eNOS) and kinase insert domain receptor (KDR) messenger RNA (mRNA) expression in cultured EPCs and neointima. In conclusion, intensive statin therapy could be considered a favorable option to improve small-diameter vascular graft patency.
Jie Li
Department of Vascular Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. lijie3218@sina.com
Lu
Wei-Ming
WM
Li
Xiao-Xi
XX
Wang
Shen-Ming
SM
Yu
Jian-Xing
JX
Zhu
Yi-Fan
YF
Liu
Da-Yue
DY
Huang
Ming-Qing
MQ
D000818:Animals; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery; D000069059:Atorvastatin; D001807:Blood Vessel Prosthesis; D002448:Cell Adhesion / Q000187:drug effects; D002465:Cell Movement / Q000187:drug effects; D004285:Dogs; D042783:Endothelial Cells / Q000187:drug effects / Q000473:pathology; D004730:Endothelium, Vascular / Q000187:drug effects*; D006083:Graft Occlusion, Vascular / Q000473:pathology*; D006538:Heptanoic Acids / Q000494:pharmacology*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008855:Microscopy, Electron, Scanning; D019001:Nitric Oxide Synthase / Q000032:analysis; D011138:Polytetrafluoroethylene; D011182:Postoperative Care; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D011758:Pyrroles / Q000494:pharmacology*; D013234:Stem Cells / Q000187:drug effects / Q000473:pathology; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000187:drug effects; D014654:Vascular Patency / Q000187:drug effects
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D011138:Polytetrafluoroethylene; D000069059:Atorvastatin; D019001:Nitric Oxide Synthase; D040301:Vascular Endothelial Growth Factor Receptor-2