Experimental carotid stenosis due to fibrous intimal hyperplasia

Although fibrous intimal hyperplasia has been reported to be involved in up to one-third of recurrences of carotid restenosis following endarterectomy, little is known of its origin. This prompted us to attempt to produce it experimentally. Fibrous intimal hyperplasia could not be induced in the canine carotid model using simple endarterectomy or endarterectomy with an autogenous vein patch angioplasty. Polytetrafluoroethylene graft angioplasties in the same model produced this lesion readily and usually led to stenosis or occlusion. The experimental and clinical lesion of fibrous intimal hyperplasia of the carotid artery and the lesion of intimal fibrous hyperplasia that occurs when prosthetic arterial grafts are placed into small and medium size arteries appear histologically similar and may be due to a common factor. A review of the factors available in our series, as well as those of others, leads us to believe that the common denominator is hemodynamic in nature. The experimental data showing stenotic fibrous intimal hyperplasia occurring with polytetrafluoroethylene patch angioplasties has been previously reported. These data indicate that polytetrafluoroethylene should cautiously be used for small and medium diameter arterial patch angioplasties.