title: The use of external mesh reinforcement to reduce intimal hyperplasia and preserve the structure of human saphenous veins.
abstract: The saphenous vein is the conduit of choice in bypass graft procedures. Haemodynamic factors play a major role in the development of intimal hyperplasia (IH), and subsequent bypass failure. To evaluate the potential protective effect of external reinforcement on such a failure, we developed an ex vivo model for the perfusion of segments of human saphenous veins under arterial shear stress. In veins submitted to pulsatile high pressure (mean pressure at 100 mmHg) for 3 or 7 days, the use of an external macroporous polyester mesh 1) prevented the dilatation of the vessel, 2) decreased the development of IH, 3) reduced the apoptosis of smooth muscle cells, and the subsequent fibrosis of the media layer, 4) prevented the remodelling of extracellular matrix through the up-regulation of matrix metalloproteinases (MMP-2, MMP-9) and plasminogen activator type I. The data show that, in an experimental ex vivo setting, an external scaffold decreases IH and maintains the integrity of veins exposed to arterial pressure, via increase in shear stress and decrease wall tension, that likely contribute to trigger selective molecular and cellular changes.
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Alban
authors.initials: A
authors.lastname: Longchamp
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Florian
authors.initials: F
authors.lastname: Alonso
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Céline
authors.initials: C
authors.lastname: Dubuis
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Florent
authors.initials: F
authors.lastname: Allagnat
authors.affiliation: Department of Vascular Surgery, Pellegrin Hospital, Univ. Bordeaux, Place Amelie Raba Leon, 33000 Bordeaux, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Berard
authors.affiliation: Department of Cell Physiology and Metabolism, University of Geneva, School of Medicine, CMU, 1211 Genève 4, Switzerland.
authors.forename: Paolo
authors.initials: P
authors.lastname: Meda
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Saucy
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Corpataux
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Déglise
authors.affiliation: Department of Thoracic and Vascular Surgery, University Hospital, Laboratory of Experimental Medicine, Bugnon 21, 1011 Lausanne, Switzerland. Electronic address: Jacques-Antoine.Haefliger@chuv.ch.
authors.forename: Jacques-Antoine
authors.initials: JA
authors.lastname: Haefliger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D053148:Caspase 3 / Q000378:metabolism; D015536:Down-Regulation; D036388:Ephrin-B2 / Q000235:genetics / Q000378:metabolism; D005260:Female; D006419:Heme Oxygenase (Decyclizing) / Q000378:metabolism; D006801:Humans; D006965:Hyperplasia; D066298:In Vitro Techniques; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D032389:Myocytes, Smooth Muscle / Q000378:metabolism / Q000473:pathology; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D010477:Perfusion; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D011312:Pressure; D036224:Receptor, EphB4 / Q000235:genetics / Q000378:metabolism; D012501:Saphenous Vein / Q000201:enzymology / Q000473:pathology*; D013314:Stress, Mechanical; D054457:Tissue Scaffolds / Q000737:chemistry*; D016212:Transforming Growth Factor beta / Q000378:metabolism; D017539:Tunica Intima / Q000473:pathology*
chemical_list: D036388:Ephrin-B2; D017395:Plasminogen Activator Inhibitor 1; D016212:Transforming Growth Factor beta; D052250:Nitric Oxide Synthase Type III; D006419:Heme Oxygenase (Decyclizing); D036224:Receptor, EphB4; D053148:Caspase 3; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9
keywords: Caspase-3; External polyester mesh reinforcement; Intimal hyperplasia; MMPs; Shear stress; Vein graft