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Updated: Nov 1, 2025
Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency
Published on: January 15, 2017
[Comparative study of vasa vasorum and neointima in conduits for coronary artery bypass grafting]
A V Frolov1, A A Terekhov1, L A Bogdanov1
1Laboratory of Fundamental Aspects of Atherosclerosis, Division of Experimental Medicine, Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia.
Insights
Intimal hypertrophy in coronary artery bypass grafting conduits is linked to vasa vasorum. The great saphenous vein shows a higher vasa vasorum density, suggesting a predisposition to intimal hypertrophy.
Area of Science:
- Vascular biology
- Cardiovascular surgery
- Histopathology
Background:
- Coronary artery bypass grafting (CABG) relies on arterial and venous conduits.
- Intimal hypertrophy (IH) and vasa vasorum (VV) presence impact graft patency.
- Understanding preoperative conduit characteristics is crucial for surgical success.
Purpose of the Study:
- To investigate the preoperative incidence and severity of intimal hypertrophy (IH) in arterial and venous conduits for CABG.
- To assess the blood supply characteristics, specifically the vasa vasorum (VV), of these conduits.
- To explore the relationship between IH, VV, and conduit stenosis.
Main Methods:
- Segments of internal thoracic artery (ITA) and great saphenous vein (GSV) were harvested from 13 CABG patients.
- Scanning electron microscopy (SEM) was used for visualization.
- ImageJ software analyzed IH incidence, thickness, and VV number and area.
Main Results:
- IH was observed in 69.2% of GSVs and 55.8% of ITAs, without statistical significance.
- IH thickness correlated with stenosis percentage, VV area, and VV number.
- GSVs exhibited a significantly higher number of VV compared to ITAs, even after adjusting for adventitia area.
- VV number correlated more strongly with IH in GSVs than in ITAs.
Conclusions:
- Intimal hypertrophy in CABG conduits is associated with the number and area of vasa vasorum.
- The great saphenous vein demonstrates a greater density of vasa vasorum compared to the internal thoracic artery.
- The findings suggest a potential predisposition of the great saphenous vein to adventitial inflammation and subsequent intimal hypertrophy.
Aim:
This study was undertaken to investigate the preoperative incidence and severity of intimal hypertrophy, as well as the level of blood supply of arterial and venous conduits for coronary artery bypass grafting.
Material And Methods:
Segments of the internal thoracic artery and great saphenous vein (n=13) were harvested pairwise during coronary artery bypass grafting and were then visualized by scanning electron microscopy in back-scattered electrons. The analysis of the incidence and thickness of intimal hypertrophy, as well as the calculation of the number and the area of the vasa vasorum were performed using the programme ImageJ.
Results:
Intimal hypertrophy was more characteristic for the great saphenous vein as compared with the internal thoracic artery (9/13 (69.2%) and 7/13 (55.8%), respectively), although this difference did not reach statistical significance. The maximal-to-minimal neointimal thickness ratio correlated with the percentage of stenosis (r=0.875, p<0.0001), the area (r=0.45, p=0.023) and the number (r=0.47, p=0.015) of the vasa vasorum in the conduits, thus confirming the hypothesis on possible participation of these vessels in the development of intimal hypertrophy, with the area of the vasa vasorum being greater in the vessels with >10% stenosis (p=0.051). The number of the vasa vasorum in the great saphenous vein exceeded that in the internal thoracic artery (p=0.0005), with this difference remaining significant after adjustment for the area of the adventitia (p=0.027). The number of the vasa vasorum per the percentage of stenosis in the great saphenous vein also exceeded that in the internal thoracic artery (p=0.039) and more strongly correlated with intimal hypertrophy in the great saphenous vein as compared with that in the internal thoracic artery (r=0.53 and r=0.27, respectively).
Conclusion:
Intimal hypertrophy correlates with the area and number of the vasa vasorum in conduits. The great saphenous vein is characterised by a larger number and higher density of the vasa vasorum as compared with the internal thoracic artery. The number of the vasa vasorum is correlated with stenosis of the great saphenous vein more closely than with stenosis of the internal thoracic artery. This may be suggestive of significant predisposition of the great saphenous vein to the onset of adventitial inflammation followed by the development of intimal hypertrophy.
