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Re-endothelialisation in autogenous vein grafts

M Ishikawa1, T Sasajima, Y Kubo

  • 1First Department of Surgery, Asahikawa Medical College, Japan.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|January 1, 1996
PubMed
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Preparing autogenous vein grafts in heparinized autogenous blood significantly improves endothelial cell coverage post-implantation compared to saline. This method enhances graft healing, though complete re-endothelialisation remains a challenge.

Area of Science:

  • Vascular surgery
  • Tissue engineering
  • Endothelial cell biology

Background:

  • Endothelialization is crucial for vascular graft patency.
  • Preservation of endothelial cells during graft preparation impacts healing.
  • Autogenous vein grafts are susceptible to endothelial cell loss.

Purpose of the Study:

  • To investigate the re-endothelialisation (Re-E) process in canine femoral artery vein grafts.
  • To evaluate the effect of different immersion media on endothelial cell preservation and graft healing.

Main Methods:

  • Autogenous canine femoral veins were immersed in either heparinized saline or heparinized autogenous blood.
  • Grafts were implanted into the contralateral femoral artery.
  • Grafts were retrieved at intervals from 1 day to 8 weeks post-implantation for analysis.

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Main Results:

  • Grafts prepared in heparinized autogenous blood showed higher initial endothelial cell coverage (73.5%) compared to heparinized saline (44.9%).
  • Endothelial cell coverage at 4 weeks was significantly higher in the blood group (95.5%) versus the saline group (81.3%).
  • Re-E slowed considerably after 1 week in the blood group, and remained incomplete even at 8 weeks in both groups.

Conclusions:

  • Heparinized autogenous blood is recommended as a superior immersion medium for autogenous vein grafts.
  • Endothelial cells largely detach early post-implantation, regenerating irregularly.
  • Incomplete re-endothelialisation may contribute to intimal hyperplasia development.