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Diabetes mellitus and experimental vein graft structure and function
M G Davies1, J H Kim, M L Klyachkin
1Department of Surgery, Duke University Medical Center, Durham, NC 27710.
Journal of Vascular Surgery
|June 1, 1994
Summary
Diabetes mellitus significantly increases vein graft intimal thickness and contractility, leading to a higher risk of early stenosis in diabetic patients. This study highlights the detrimental effects of diabetes on vascular grafts.
Area of Science:
- Vascular Biology
- Diabetology
- Surgical Research
Background:
- Diabetes mellitus is a significant risk factor for cardiovascular diseases, including accelerated atherosclerosis.
- Postangioplasty restenosis is a common complication, and diabetes exacerbates this risk.
Purpose of the Study:
- To investigate the impact of chronic, uncontrolled diabetes on the structural and functional integrity of vein bypass grafts.
- To assess the susceptibility of vein grafts to early stenosis in a diabetic model.
Main Methods:
- Alloxan-induced diabetes was established in male New Zealand white rabbits.
- Vein bypass grafts were surgically created and harvested after 8 weeks of diabetes, with contralateral jugular veins as controls.
- Vein graft structure and vasomotor function were analyzed using light and electron microscopy.
Main Results:
- Diabetes led to a twofold increase in vein graft intimal thickness, without affecting medial thickness.
- Endothelial alterations, including intercellular gaps and abnormal cell junctions, were observed in diabetic vein grafts.
- Maximal contractile responses of vein grafts were significantly elevated in diabetic rabbits.
Conclusions:
- Diabetes adversely affects endothelial cell structure and promotes intimal hyperplasia in vein grafts.
- Increased contractility and intimal hyperplasia suggest vein grafts in diabetic individuals are prone to early stenosis.
- These findings underscore the heightened risk of graft failure in diabetic patients undergoing bypass surgery.