Flow reversal promotes intimal thickening in vein grafts

摘要: Objective After vascular interventions, unidentified mechanisms disrupt the homeostasis of a focal narrowing to initiate an intimal thickening response. We hypothesize that perturbations in hemodynamic microenvironment are initiating event for this disruption and vein bypass grafts. The objective study was investigate relation between local flow its influence on graft architecture. Methods An external ligature used create 80% midgraft stenosis bilateral rabbit carotid A unilateral distal ligation created ninefold difference rate high-flow low-flow Ten grafts were harvested at 28 days serially sectioned morphologic evaluation reconstruction. Computational fluid dynamics analyses performed examine environment within these complex regions. Results largest occurred exclusively region immediately maximum grafts, which characterized by persistent separation reversal entire cardiac cycle. In regions low moderate shear stress ( Conclusions Regions exposed most risk loss lumen.