Inhibition of vein graft intimal hyperplasia by periadventitial application of hyaluronic acid-carboxymethyl cellulose: an experimental study.

Abstract

OBJECTIVE: Placement of an external support has been reported to prevent intimal hyperplasia of vein grafts. In this study, we investigated the effect of HA/CMC on intimal hyperplasia in a rabbit model. DESIGN: Right jugular vein to common carotid artery bypass grafting was performed in 24 female New Zealand white rabbits (2.5-3.0 kg). Animals were divided into two groups: control group (n=12) and HA/CMC group (n=12). Absorbable membrane barrier was wrapped around vein grafts in HA/CMC group. In control group, no material was applied following venous graft bypass. RESULTS: At 1 month, in the vein grafts supported with the HA/CMC membrane neointimal thickening was significantly less (109 microm [IQR, 78-166]) compared to the unsupported control grafts (220 microm [IQR; 101-312]; p<0.001). Medial thickening in the HA/CMC group (128 microm [IQR, 101-181]) compared to unsheathed control grafts (182 microm [IQR, 131-255] p<0.001) was also significantly less. CONCLUSION: Periadventitial placement of HA/CMC as an absorbable membrane inhibits intimal hyperplasia of vein bypass grafts in a rabbit model.