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KMID : 0371319940460060913
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Journal of the Korean Surgical Society
1994 Volume.46 No. 6 p.913 ~ p.923
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The Effect of Autogenous Endothelial Cell Seeding on Prosthetic Arterial Bypass Grafts in Dogs
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도병수
김상운/허영수/서보양/심민철/권굉보/성언기/이융창
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Abstract
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Intimal hyperplasia is a main cause of failure in arterial bypass gragft. The absence or injury of vascular endothelial lining cause platelet aggregation, thrombi formation and secretion of PDGF(platelet derived growth factor), and which
ultimately
promote smooth muscle cell proliferation and intimal hyperplasia. The purpose of this investigation was to compare the occurrence and progression of intimal hyperplasia in EC(endothelial cell) seeded PTFE (polytetrafluoroethylene) arterial bypass
graft
with that in unseeded PTFE graft. Two lve adult mongrel dogs were used.
The control grafts used were PTFE of 4mm in internal diameter and 5cm in length. The experimental grafts used were same sized PTFE seeded with EC.
ECs were harvested from 10cm autogenous external jugular vein using 1% collagenase solution. The experimental graft was seeded immediately prior to implantation with enzymatically harvested ECs. All graft anastomoses were performed bilaterally in
12
dogs bypassing the artificially excised ileofelmoral artery in length of 3cm with control grafts on right side and with experimental grafts on left side. Both grafts were removed from three dogs each time at 1, 2, 4 and 6 weeks after implantation
for
microscopic examination.
The total number of grafts microscopically evaluated was 12 unseeded and 12 seeded PTFE. The light and electron microscopic findings of both control and experimental grafts were compared with each time period.
Through light microscopy more rapid endothelialization was noted in luminal surface of experimental grafts than in control during same periods. Experimental grafts, in contrast to control grafts, exhibited a thinner intima and a less developed
smooth
muscle cell layer. Electron microscopic sections showed endothelial cell-specific Weible-Palade granules and numerous pinocytotic vesicles. Smooth muscle cells and fibroblast oriented along the graft flow axis were loosely organized in
subendothelial
space including abundant polyribosomes, myofilaments, rough endoplasmic reticula and well developed Golgi apparatus.
In conclusion, early EC coverage of heointima surface inhibits excessive growth of smooth muscle cells and the development of intimal hyperplasia.
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KEYWORD
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