E-ISSN 2146-8133
 

Original Research (Original Article) 


Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support

Samy Nitecki, Liad Yosef, Matteo Tozzi, Rona Shofti.

Abstract
Objective: Despite significant advances in the understanding of vein graft remodeling during the post-implantation, vein graft disease is still a major limitation of surgical revascularization. The study objective was to evaluate the performance of a new cobalt chrome external support device designed to mitigate vein graft remodeling and development of intimal hyperplasia.
Methods: Bilateral carotid interposition of reversed saphenous vein graft segments was performed in seven‏ adult sheep. Following completion of the first anastomosis, randomization was performed to allocate the experimental and control grafts in each animal. Post-procedure, Doppler US was used to assess grafts lumen diameter at T0 and then 3-5 and 12-14 weeks after surgery. At 12-14 weeks, all sheep underwent angiography to assess grafts patency and lumen uniformity (coefficient of variance - CV) after which they were sacrificed, and all grafts were harvested for microscopic histological analysis.
Results: Baseline (T0) internal diameter was not significantly different between the supported and unsupported grafts. At twelve to fourteen weeks, the internal diameter of supported grafts remained unchanged and was significantly lower compared to the non-supported grafts (6.6mm±0.4mm vs. 12.8mm±4.0mm respectively, p= 0.0001). Percentage coefficient of variance (%CV) was 4.6%±4.3 in the supported grafts as opposed to average CV% of 14.7%±6.5 in the non-stented group (p=0.011). Neointimal area was significantly lower in the stented compared to the non-stented group (1.4 mm2±3.3mm2 versus 9.6mm2±9.7mm2 respectively, p=0.009).
Conclusions: External support of vein grafts using a braided cobalt chrome external stent reduces early vein graft remodeling and mitigates the development of neointimal hyperplasia.

Key words: Peripheral bypass, vein graft, intimal hyperplasia, graft patency, infrainguinal bypass, external support


 
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Pubmed Style

Nitecki S, Yosef L, Tozzi M, Shofti R. Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. Arch Clin Exp Surg. 2018; 7(3): 108-115. doi:10.5455/aces.20171128090019


Web Style

Nitecki S, Yosef L, Tozzi M, Shofti R. Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. http://www.ejmaces.com/?mno=283002 [Access: September 25, 2018]. doi:10.5455/aces.20171128090019


AMA (American Medical Association) Style

Nitecki S, Yosef L, Tozzi M, Shofti R. Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. Arch Clin Exp Surg. 2018; 7(3): 108-115. doi:10.5455/aces.20171128090019



Vancouver/ICMJE Style

Nitecki S, Yosef L, Tozzi M, Shofti R. Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. Arch Clin Exp Surg. (2018), [cited September 25, 2018]; 7(3): 108-115. doi:10.5455/aces.20171128090019



Harvard Style

Nitecki, S., Yosef, L., Tozzi, M. & Shofti, R. (2018) Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. Arch Clin Exp Surg, 7 (3), 108-115. doi:10.5455/aces.20171128090019



Turabian Style

Nitecki, Samy, Liad Yosef, Matteo Tozzi, and Rona Shofti. 2018. Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. Archives of Clinical and Experimental Surgery (ACES), 7 (3), 108-115. doi:10.5455/aces.20171128090019



Chicago Style

Nitecki, Samy, Liad Yosef, Matteo Tozzi, and Rona Shofti. "Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support." Archives of Clinical and Experimental Surgery (ACES) 7 (2018), 108-115. doi:10.5455/aces.20171128090019



MLA (The Modern Language Association) Style

Nitecki, Samy, Liad Yosef, Matteo Tozzi, and Rona Shofti. "Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support." Archives of Clinical and Experimental Surgery (ACES) 7.3 (2018), 108-115. Print. doi:10.5455/aces.20171128090019



APA (American Psychological Association) Style

Nitecki, S., Yosef, L., Tozzi, M. & Shofti, R. (2018) Inhibition of vein graft remodeling and neo-intimal formation using a cobalt chrome external support. Archives of Clinical and Experimental Surgery (ACES), 7 (3), 108-115. doi:10.5455/aces.20171128090019





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