Karaagac Erturk, Besir Yuksel, Kurus Meltem, Gokalp Orhan, Iscan Sahin, Gokkurt Yasar, Kandemir Cagri, Topal Fatih Esad, Keselik Erdi, Eygi Bortecin, Gurbuz Ali
Department of Cardiovascular Surgery, Muş State Hospital, Muş, Turkey.
Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
J Biomater Appl. 2021 Jul;36(1):152-164. doi: 10.1177/0885328220964913. Epub 2020 Oct 13.
Since the systemic drugs have been used to reduce the hyperplasic response in the tunica intima, the periadventitial local drug applications to the vascular wall have gained more popularity. In this study, we investigated the effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on neointimal hyperplasia in rabbit carotid artery anastomosis to explore the effects of these two different agents.
21 New Zealand male rabbits were randomly divided into three groups. The carotid artery transection and anastomosis was performed onthe control group. The bovine serum albumin-glutaraldehyde and the polyethylene glycol polymer were applied locally on the other two groups seperatley after transection and anastomosis of the carotid arteries. At the end of 28-day follow-up, the histological and the immunohistochemical results related to neointimal hyperplasia were compared.
The glue residues were detected in the BSA-glutaraldehyde group, but in the PEG polymer group there was no glue residue. The intima thickness and the intima/media thickness ratio in the control group was significantly higher (p<0.05) than the other groups. These values did not differ significantly between the BSA-glutaraldehyde group and the PEG polymer group (p>0.05). The lumen diameter and the area in the control group were significantly higher (p < 0.05) than the BSA-glutaraldehyde group. These values between the control group and the PEG polymer group did not differ significantly (p>0.05). aSMA-positive staining score in the Control group was found to be significantly lower (p < 0.05) than the BSA-glutaraldehyde and PEG polymer group and the VEGF-positive staining score in the control group was found to be significantly higher (p < 0.05) than the BSA-glutaraldehyde and the PEG polymer group.
Although the both agents have positive results on neointimal hyperplasia, it would be favorable to use polyethylene glycol polymer, since it does not seem to affect the lumen area and the lumen diameter of the vessel.
由于全身用药已被用于减轻内膜的增生反应,血管壁外膜局部给药越来越受到关注。在本研究中,我们研究了牛血清白蛋白-戊二醛和聚乙二醇聚合物对兔颈动脉吻合处新生内膜增生的影响,以探讨这两种不同药物的作用效果。
将21只新西兰雄性兔随机分为三组。对照组进行颈动脉横断和吻合术。在另外两组中,于颈动脉横断和吻合术后分别局部应用牛血清白蛋白-戊二醛和聚乙二醇聚合物。在28天随访结束时,比较与新生内膜增生相关的组织学和免疫组化结果。
在牛血清白蛋白-戊二醛组中检测到胶水残留,但聚乙二醇聚合物组未检测到胶水残留。对照组的内膜厚度和内膜/中膜厚度比显著高于其他组(p<0.05)。牛血清白蛋白-戊二醛组和聚乙二醇聚合物组之间这些值无显著差异(p>0.05)。对照组的管腔直径和面积显著高于牛血清白蛋白-戊二醛组(p < 0.05)。对照组和聚乙二醇聚合物组之间这些值无显著差异(p>0.05)。发现对照组的α平滑肌肌动蛋白(αSMA)阳性染色评分显著低于牛血清白蛋白-戊二醛组和聚乙二醇聚合物组,对照组的血管内皮生长因子(VEGF)阳性染色评分显著高于牛血清白蛋白-戊二醛组和聚乙二醇聚合物组(p < 0.05)。
尽管两种药物对新生内膜增生均有积极效果,但使用聚乙二醇聚合物可能更有利,因为它似乎不会影响血管的管腔面积和管腔直径。