title: Inhibitory effect of sustained perivascular delivery of paclitaxel on neointimal hyperplasia in the jugular vein after open cutdown central venous catheter placement in rats.
abstract: OBJECTIVE
  Inhibitory effect of paclitaxel on neointimal hyperplasia after open cutdown has not been elucidated.
  
  
  METHODS
  For the control group (n = 16), silicone 2.7-Fr catheters were placed via the right external jugular vein with the cutdown method. For the treatment group (n = 16), a mixture of 0.65 mg of paclitaxel and 1 mL of fibrin glue was infiltrated around the exposed vein after cutdown. After scheduled intervals (1, 2, 4, and 8 weeks), the vein segment was harvested and morphometric analysis was performed on cross-sections.
  
  
  RESULTS
  Proliferation of smooth muscle cell (SMC) was strongly suppressed in the treatment group, and the ratio of neointima to vein wall was significantly reduced in the treatment group (8 weeks; 0.63 ± 0.08 vs. 0.2 ± 0.08, P < 0.05). Luminal patency was significantly more preserved in the treatment group, and the luminal area was significantly wider in the paclitaxel-treated group compared to the control group (8 weeks; 1.91 ± 0.43 mm2vs. 5.1 ± 0.43 mm2, P < 0.05). Mean SMC counts measured at 1 and 2 weeks after cutdown were significantly lower in the treatment group (2 weeks; 115 ± 22 vs. 62 ± 22). Paclitaxel was undetectable in systemic circulation (<10 ng/mL).
  
  
  CONCLUSIONS
  Sustained perivascular delivery of paclitaxel with fibrin glue was effective in inhibiting neointimal hyperplasia in rat jugular vein after open cutdown.
authors.affiliation: Department of General Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Seongyup
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Surgery, Kangwon National University School of Medicine, Chuncheon, Korea.
authors.forename: Younglim
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea.
authors.forename: Ji Woong
authors.initials: JW
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Kangwon National University School of Medicine, Chuncheon, Korea.
authors.forename: Suk-Bae
authors.initials: SB
authors.lastname: Moon
keywords: Central venous catheters; Fibrin; Jugular veins; Neointima; Paclitaxel