title: Oversized vein grafts develop advanced atherosclerosis in hypercholesterolemic minipigs.
abstract: BACKGROUND
  Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis.
  
  
  METHODS
  An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were investigated 12-14 weeks later with ultrasound and angiograpy in vivo and microscopy post mortem.
  
  
  RESULTS
  One minipig died during follow up (patent vein graft at autopsy), and one vein graft thrombosed early. In the remaining eight patent vein grafts, the mean (standard deviation) intima-media thickness was 712 μm (276 μm) versus 204 μm (74 μm) in the contralateral control internal jugular veins (P < .01). Advanced atherosclerotic plaques were found in three of four oversized vein grafts (diameter of graft > diameter of artery). No plaques were found in four non-oversized vein grafts (P < .05).
  
  
  CONCLUSIONS
  Our model of jugular vein graft in the common carotid artery of hypercholesterolemic minipigs displayed the components of human vein graft disease, i.e. thrombosis, intimal hyperplasia, and atherosclerosis. Advanced atherosclerosis, the main cause of late failure of human aortocoronary vein grafts was only seen in oversized grafts. This finding suggests that oversized vein grafts may have detrimental effects on patient outcome.
authors.affiliation: Atherosclerosis Research Unit, Department of Cardiology, Aarhus University Hospital and Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark. troels.thim@ki.au.dk
authors.forename: Troels
authors.initials: T
authors.lastname: Thim
authors.forename: Mette Kallestrup
authors.initials: MK
authors.lastname: Hagensen
authors.forename: Arne
authors.initials: A
authors.lastname: Hørlyck
authors.forename: Ludovic
authors.initials: L
authors.lastname: Drouet
authors.forename: William P
authors.initials: WP
authors.lastname: Paaske
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.forename: Erling
authors.initials: E
authors.lastname: Falk
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000209:etiology* / Q000473:pathology; D017536:Carotid Artery, Common / Q000601:surgery; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000473:pathology*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000601:surgery*; D007601:Jugular Veins / Q000473:pathology / Q000637:transplantation*; D013552:Swine; D013556:Swine, Miniature