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Related Experiment Videos

Pre-bypass morphological changes in vein grafts

A H Davies1, T R Magee, R N Baird

  • 1Department of Vascular Studies and Histopathology, Bristol Royal Infirmary, U.K.

European Journal of Vascular Surgery
|November 1, 1993
PubMed
Summary

Veins used for bypass surgery, including the long saphenous vein, show significant pathological changes like intimal hyperplasia. These changes, especially in distal segments, may impact bypass surgery outcomes.

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Area of Science:

  • Vascular Surgery
  • Histopathology
  • Surgical Pathology

Background:

  • Veins used in bypass grafting are often presumed to be healthy.
  • Pre-operative pathological changes in these veins may affect surgical success.

Purpose of the Study:

  • To investigate pathological features in long saphenous veins (LSV) and cephalic arm veins used for femoro-distal bypass.
  • To determine if these "normal" veins exhibit changes that could influence bypass graft patency.

Main Methods:

  • Histological examination of proximal and distal LSV segments from 85 patients undergoing femoro-distal bypass.
  • Analysis of three cephalic arm vein samples using hematoxylin and eosin and van Geison stains.

Main Results:

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  • Intimal hyperplasia was prevalent in 73% of proximal and 87% of distal LSV samples.
  • Distal LSV segments showed significantly higher rates of moderate to severe focal hyperplasia and circular muscle hypertrophy (p < 0.05 and p < 0.001).
  • Muscle hypertrophy was more common in distal (88%) versus proximal (68%) LSV segments (p < 0.005).

    • Conclusions:

    • Significant pathological changes, including intimal hyperplasia and muscle hypertrophy, are present in veins considered suitable for bypass surgery.
    • These changes are more pronounced in the distal segments of the long saphenous vein.
    • Pre-existing venous pathology may be a critical factor affecting the long-term success of vein bypass grafts.