[Reduction of atherogenesis in an arterialized venous graft by using an external sleeve]

The parietal thickening of a vein under hemodynamical conditions in the arterial system can be reduced when supporting the vein with a rigid external sleeve. To assess the role of thickness reduction in atherogenesis of an arterialized vein graft, a 4 mm thick external sleeve was implemented around the proximal half of a carotid-carotid vein graft in 16 New Zealand rabbits. Eleven rabbits were submitted to a hypercholesterolemic diet (HC group), while five others were submitted to a normal cholesterol diet (NC group). After eight weeks, a statistically significant difference in thickness was observed between free and sleeved segments, in the NC group with 105 +/- 9 microns versus 65 +/- 6 microns (p < 10.0001) respectively as well as in the HC group with 180 +/- 37 microns versus 99 +/- 35 microns (p < 10.0001) respectively. Studying the extent of soudanophilic lesions showed a statistically significant difference according to the use or not of an external sleeve where average extent is 68 +/- 17% in free segments versus 31 +/- 26% (p < 10.0001) is sleeved segments. The reduction in vein overfullness using an external constrictive sleeve prevents structural parietal changes in the vein and allows reducing atherogenesis of the arterialized vein graft.