title: The role of short-term oxygen administration in the prevention of intimal hyperplasia.
abstract: OBJECTIVE
  Intimal hyperplasia (IH) is the cause of most failed arteriovenous fistulas (AVFs), resulting in repeat procedures and leading to increased utilization of scarce health care resources. Our laboratory has previously demonstrated the role of supplemental oxygen in preventing IH and smooth muscle cell proliferation (SMCp) at an artery-to-graft anastomosis and at the deployment site of an intra-arterial stent. This study examines the effect of supplemental oxygen in preventing IH and SMCp in an AVF in a rabbit model.
  
  
  METHODS
  Ninety-six rabbits were randomized into four groups: group 1, control; group 2, no surgery with supplemental oxygen; group 3, AVF without supplemental oxygen; and group 4, AVF with supplemental oxygen. Rabbits receiving supplemental oxygen received 30% oxygen for up to 42 days. Specimens were collected in all groups at days 1, 3, 7, 21, 42, and 90. IH and SMCp were measured at the AVF site as well as in the artery and vein proximal and distal to the AVF.
  
  
  RESULTS
  IH was first noted at day 7 and significantly increased through day 90 at all locations in the nonoxygen-supplemented groups. No significant IH was noted in the oxygen-supplemented group at any location or any time point. SMCp was noted at day 3 through day 21 in the nonoxygen-supplemented group, whereas almost no SMCp was noted in the oxygen-supplemented group at any location or time point.
  
  
  CONCLUSIONS
  Without oxygen supplementation, SMCp begins at day 3 and is no longer noted at day 21 after creation of an AVF, whereas IH begins by day 7 and increases at least through day 90 after creation of an AVF. Forty-two days of 30% supplemental oxygen inhibits IH and SCMp after creation of an AVF. These data suggest a role for the short-term administration of low-dose O2 to prevent both IH and SMCp after creation of an AVF that may prolong patency and function.
authors: Department of Surgery, University of Minnesota and Minneapolis Veterans Health Care System, Minneapolis, MN 55455, USA.
authors: Charu
authors: C
authors: Lata
authors: Derrick
authors: D
authors: Green
authors: Jing
authors: J
authors: Wan
authors: Sabita
authors: S
authors: Roy
authors: Steven M
authors: SM
authors: Santilli
mesh_terms: D000818:Animals; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D049109:Cell Proliferation; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D006965:Hyperplasia; D007083:Iliac Artery / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007084:Iliac Vein / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D058426:Neointima; D010102:Oxygen Inhalation Therapy; D011817:Rabbits; D013997:Time Factors; D014654:Vascular Patency
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