Influence of systemic factors on pre-existing intimal hyperplasia and their effect on the outcome of infrainguinal arterial reconstruction with vein
| Autor: | M. Sian, Alun H. Davies, David K. Beattie, Roger M. Greenhalgh |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Intimal hyperplasia Homocysteine Biopsy Fibrinogen chemistry.chemical_compound Blood Vessel Prosthesis Implantation Internal medicine medicine Humans Saphenous Vein Vein Aged Aged 80 and over Peripheral Vascular Diseases Hyperplasia medicine.diagnostic_test Vascular disease business.industry Graft Survival Middle Aged Plastic Surgery Procedures medicine.disease Surgery medicine.anatomical_structure Treatment Outcome chemistry Cardiology Female business Tunica Intima medicine.drug Artery Lipoprotein(a) |
| Zdroj: | The British journal of surgery. 86(11) |
| ISSN: | 0007-1323 |
| Popis: | Background The association between raised levels of homocysteine, fibrinogen and lipoprotein (a), and the presence of pre-existing intimal hyperplasia (IH) in vein has not been assessed. The positive association between such hyperplasia and graft failure following infrainguinal arterial reconstruction, and between lipoprotein (a) and graft failure, is disputed. The influence of homocysteine on outcome has not been investigated prospectively. Methods Fifty-seven patients (63 grafts) undergoing infrainguinal arterial reconstruction with saphenous vein were studied. Homocysteine, fibrinogen and lipoprotein (a) levels were measured, and a vein biopsy was taken at operation. Patients underwent graft surveillance and outcome at 12 months was determined. Results Fifty-seven per cent of patients had hyperhomocysteinaemia. Patients with pre-existing IH had significantly higher homocysteine levels. There was no association between homocysteine and outcome, or between fibrinogen and pre-existing IH or outcome. Lipoprotein (a) levels were significantly lower in patients with pre-existing disease, and were lower, but not significantly, in those whose grafts failed. The correlation between pre-existing IH and vein graft failure was highly significant. Conclusion Hyperhomocysteinaemia is associated with peripheral vascular disease and the development of pre-existing IH in vein, which itself is associated with vein graft failure. |
| Databáze: | OpenAIRE |
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