title: Influence of ischemia before vein grafting on early hyperplasia of the graft and the dynamic changes of the intima after grafting.
abstract: BACKGROUND
  To investigate both the influence of ischemia before grafting on early hyperplasia of the vein grafts, and the dynamic changes of the intima after grafting in a rabbit model of vein graft disease.
  
  
  METHODS
  We performed paired vein graft experiments under different ischemic conditions (15 vs. 60 min; 15 vs. 90 min) in the neck of the rabbits and compared the differences between the grafts. Clopidogrel, an anti-platelet agent, was administered before and after surgery. Twenty-eight days after the grafting procedure, the veins were evaluated microscopically. The dynamic changes of the intima after grafting were evaluated by scanning electron microscopy over time.
  
  
  RESULTS
  The vein grafts subjected to 60- or 90-min ischemia exhibited no differences compared to those subjected to 15-min ischemia in terms of the mean thickness of the intimal, medial, and adventitial layers of the graft. Similarly, there was no difference in the Ki-67 labeling index (proliferation marker) between the vein grafts. Vein grafts with 15-min ischemia lost endothelial cells (ECs) but healed by 3 days post graft, whereas vein grafts with 90-min ischemia suffered serious EC loss, which was restored with new ECs during days 2 to 14 post graft.
  
  
  CONCLUSIONS
  Ninety-minute ischemia before vein grafting can cause serious EC loss, but does not increase early intimal hyperplasia when clopidogrel is administered. Protecting the vein from ischemia and reperfusion injury preserves ECs.
authors.affiliation: Department of Cardiothoracic Surgery, Shanghai No6 People's Hospital, Shanghai JiaoTong University, 600 YiShan Road, Shanghai, 200233, China.
authors.forename: Rongjiang
authors.initials: R
authors.lastname: Zou
authors.forename: Mingjuan
authors.initials: M
authors.lastname: Sun
authors.forename: ZhiQian
authors.initials: Z
authors.lastname: Lu
authors.forename: Qingkui
authors.initials: Q
authors.lastname: Guo
mesh_terms: D000818:Animals; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D049109:Cell Proliferation / Q000187:drug effects; D000077144:Clopidogrel; D042783:Endothelial Cells / Q000166:cytology* / Q000187:drug effects; D006651:Histocytochemistry; D006965:Hyperplasia / Q000378:metabolism / Q000473:pathology; D007511:Ischemia / Q000503:physiopathology*; D019394:Ki-67 Antigen / Q000378:metabolism; D008855:Microscopy, Electron, Scanning; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D011817:Rabbits; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000494:pharmacology; D017539:Tunica Intima / Q000166:cytology* / Q000187:drug effects / Q000378:metabolism / Q000473:pathology
chemical_list: D019394:Ki-67 Antigen; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine