Bush H L, Jakubowski J A, Sentissi J M, Curl G R, Hayes J A, Deykin D
J Vasc Surg. 1987 Jan;5(1):118-25.
Neointimal hyperplasia of the arterial wall may occur after carotid endarterectomy. This proliferative lesion is a pathologic response of the injured arterial wall and may lead to progressive stenosis. We investigated the effect of endothelial cell seeding (ECS) or antiplatelet therapy with aspirin (ASA) on inhibition of this lesion in a canine model. Endarterectomies were performed in 160 carotid arteries; 46 endarterectomies were treated perioperatively with aspirin (325 mg per day), 34 were seeded with a high density (3 X 10(6)) of autogenous endothelial cells, and 80 were untreated control arteries. At selected time intervals, the patent arteries were perfusion-fixed and the cross-sectional area (measured in square millimeters) of neointimal hyperplasia was measured by means of digital planimetry. At 6 weeks, patency of the endarterectomized carotid artery was 88% in the ASA and ECS groups, in contrast to 35% in the control group (p less than 0.01). The cross-sectional area of neointimal hyperplasia was not significantly different in the ASA and the control groups at 6 weeks. However, the ECS group showed a marked reduction in neointimal hyperplasia at 6 weeks (p less than 0.01). This inhibition of neointimal hyperplasia after carotid endarterectomy by ECS may reflect accelerated luminal healing or a direct inhibition of smooth muscle cell proliferation in the injured arterial wall.
颈动脉内膜切除术后动脉壁可能会出现新生内膜增生。这种增殖性病变是受损动脉壁的一种病理反应，可能导致进行性狭窄。我们在犬类模型中研究了内皮细胞种植（ECS）或阿司匹林（ASA）抗血小板治疗对抑制这种病变的效果。对160条颈动脉进行了内膜切除术；46条内膜切除术在围手术期用阿司匹林（每天325毫克）治疗，34条植入高密度（3×10⁶）的自体内皮细胞，80条作为未治疗的对照动脉。在选定的时间间隔，对通畅的动脉进行灌注固定，并通过数字平面测量法测量新生内膜增生的横截面积（以平方毫米为单位）。6周时，ASA组和ECS组颈动脉内膜切除术后的通畅率为88%，而对照组为35%（p<0.01）。6周时，ASA组和对照组新生内膜增生的横截面积无显著差异。然而，ECS组在6周时新生内膜增生明显减少（p<0.01）。ECS对颈动脉内膜切除术后新生内膜增生的这种抑制作用可能反映了管腔愈合加速或对受损动脉壁平滑肌细胞增殖的直接抑制。
