Over 150,000 vein graft procedures are performed annually in the United States. Of the grafts which fail, 25% do so because of adverse changes occurring within the grafted vein itself. The long-term objective of this proposal is to study the pathogenesis of the adverse morphologic changes occurring within these grafts, with the aim to devise methods of prevention. Transplantation of a vein to the arterial circulation invariably results in desquamation of the venous endothelium from large areas. This luminal surface is subsequently covered with blood elements, principally platelets and leukocytes. It is the specific aim of the studies in this proposal to evaluate the role of the endothelium, blood platelets, monouclear cells, and granulocytes in the morphologic changes that occur in veins transplanted into the arterial circulation. This will be accomplished by labelling these cells with radioactive tracers and observing their accumulation and disappearance on the surface of grafts placed in animals. These observations will be correlated with the morphologic changes in the intima of vein grafts over time. The effect of anticoagulant and antiplatelet drugs will be tested in these systems, with the long-term goal of establishing methods to minimize the deleterious changes that occur in vein grafts, and thereby increase the success of vein graft surgery.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL032720-03
Application #
3344161
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Project Start
1984-07-01
Project End
1987-06-30
Budget Start
1986-07-01
Budget End
1987-06-30
Support Year
3
Fiscal Year
1986
Total Cost
Indirect Cost
Name
Duke University
Department
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
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Schwartz, L B; O'Donohoe, M K; Purut, C M et al. (1992) Myointimal thickening in experimental vein grafts is dependent on wall tension. J Vasc Surg 15:176-86
Schwartz, L B; Radic, Z S; O'Donohoe, M K et al. (1992) Saphenous vein endothelium-dependent relaxation in patients with peripheral vascular disease. Ann Vasc Surg 6:425-32
Schwartz, L B; Purut, C M; O'Donohoe, M K et al. (1991) Quantitation of vascular outflow by measurement of impedance. J Vasc Surg 14:353-63
O'Donohoe, M K; Schwartz, L B; Radic, Z S et al. (1991) Chronic ACE inhibition reduces intimal hyperplasia in experimental vein grafts. Ann Surg 214:727-32
Schwartz, L B; O'Donohoe, M K; Mikat, E M et al. (1991) Effects of distention and short-term grafting on vasoreactivity in rabbit external jugular veins. Surgery 110:146-53
Radic, Z S; O'Donohoe, M K; Schwartz, L B et al. (1991) Alterations in serotonergic receptor expression in experimental vein grafts. J Vasc Surg 14:40-7
Schwartz, L B; Radic, Z S; O'Donohoe, M K et al. (1991) Functional and morphologic endothelial damage in rabbit external jugular veins stored in heparinized normal saline. Blood Vessels 28:511-9
O'Donohoe, M K; Radic, Z S; Schwartz, L B et al. (1991) Systemic hypertension alters vasomotor function in experimental vein grafts. J Vasc Surg 14:30-9

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