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J Surg Res. 2015 Jan;193(1):458-69. doi: 10.1016/j.jss.2014.07.048. Epub 2014 Jul 29.

Ovine femoral artery bypass grafting using saphenous vein: a new model.

Author information

1
Neograft Technologies, Inc, Taunton, Massachusetts. Electronic address: mkurdi@neograftinc.com.
2
Neograft Technologies, Inc, Taunton, Massachusetts.
3
Fundacion Favaloro, Buenos Aires, Argentina.
4
University of Buenos Aires, Buenos Aires, Argentina.
5
American Preclinical Services, Minneapolis, Minnesota.
6
Alizée Pathology, Thurmont, Maryland.
7
Department of Surgery, Loyola University, Maywood, Illinois; Research Services, Hines VA Hospital, Hines, Illinois.

Abstract

BACKGROUND:

Saphenous vein grafts (SVGs) are frequently used for multi-vessel coronary artery bypass grafting and peripheral arterial bypasses; however, the estimated 40% failure rate within the first 5 y due to intimal hyperplasia (IH) and the subsequent failure rate of 2%-4% per year pose a significant clinical problem. Here, we report a surgical model in sheep intended to study IH development in SVGs, which can also be used for the evaluation of potential alternative treatments.

MATERIALS AND METHODS:

Autologous bilateral SVGs were implanted as femoral artery interposition grafts using end-to-side anastomoses in adult sheep (n = 23), which were survived for 30 (n = 6), 90 (n = 7), 180 (n = 7), or 365 (n = 3) days. Post-implant, mid-term, and pretermination angiograms were quantified, and harvested SVGs were evaluated using quantitative histomorphometry.

RESULTS:

We describe a peripheral arterial surgical technique that models the progression of SVG pathology. Angiographic analysis showed a progressive dilation of SVGs leading to worsening diametrical matching to the target artery and reduced blood flow; and histomorphometry data showed an increase in IH over time. Multivariable regression analysis suggested that statistically significant (P < 0.05) time-dependent relationships exist between SVG dilation and both reduction in blood flow and IH development.

CONCLUSIONS:

Bilateral SVGs implanted onto the femoral arteries of sheep produced, controlled and consistent angiographic and histomorphometric results for which direct correlations could be made. This preclinical investigation model can be used as a robust tool to evaluate therapies intended for cardiovascular pathologies such as occlusive IH in SVGs.

KEYWORDS:

Anastomosis; Bypass graft; End-to-side; Femoral artery; No-touch vein harvest; Saphenous vein

PMID:
25151470
DOI:
10.1016/j.jss.2014.07.048
[Indexed for MEDLINE]

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