Gore-Tex small-vessel angioplasty: A suitable substitute for the use of autogenous saphenous vein grafts

Autogenous saphenous vein has been the material of choice for small-vessel angioplasty and for circulatory access graft reconstruction. In an effort to conserve autogenous saphenous vein, we used expanded polytetrafluoroethylene (PTFE) grafts in 45 patients over a 12-month period. We used Gore-Tex(*) to reconstruct 17 circulatory access grafts, 16 carotid arteries, two brachial arteries, seven femoral arteries, and three popliteal anterior or posterior tibial arteries. The indications for reconstruction were chronic occlusion of the access grafts, trauma to the brachial and anterior tibial arteries, and atherosclerotic disease of the carotid, femoral, and popliteal-tibial arteries. Of the reconstructed circulatory access grafts, one failed immediately because of technical problems in the conduit, and one failed 11 months after reconstruction. All other grafts have functioned well and have produced a marked improvement in flow. Of the 28 patients who underwent reconstruction of arteries measuring 3 mm or less, two had patent arteries but died shortly after operation. The remaining 26 have been followed for one to 43 months. All reconstructed arteries are patent, and there have been no instances of distal embolization or false aneurysm formation. From this brief experience, we conclude that Gore-Tex is a suitable short-term alternative to saphenous vein for small vessel arterioplasty; it also may be the material of choice for reconstructing the outflow tract of occluded access grafts.     

Biomechanical properties of canine vertebral and internal carotid arteries

In order to understand the participation of the geometrical and elastic properties of the large cerebral arteries in the maintenance of brain circulatory homeostasis, biomechanical properties of isolated internal carotid artery (extracranial part) and vertebral artery (intrathoracic part) were investigated both in a relaxed and in an activated (3x 10(-6) mol.l-1 norepinephrine) state of the smooth muscle. Quasi-static large deformation mechanical test was carried out by means of changing the intraluminal pressure slowly (2.5 mmHg.sec-1) and cyclicly in a range of 0-250 mmHg at in vivo length while external diameter was recorded continuously as a function of the intraluminal pressure. Maximum active tangential strain was found to be -2.7 +/- 1.6% at 70 mmHg for the internal carotid artery, and -5.9 +/- 1.1% at 100 mmHg for the vertebral artery. Incremental elastic modulus decreased and distensibility increased in both arteries following smooth muscle activation, these alterations, however, were larger in the case of the vertebral artery. A U-shaped characteristic impedance of vertebral artery was found both in relaxed and in constricted states of this vessel. Minimum values for the relaxed and the activated segments were found at 90 mmHg and 120 mmHg, respectively. These results support the hypothesis that certain biomechanical properties of the large arteries, like impedance, can be regarded as controlled variables that may contribute to the optimization of circulatory functions.     

Biaxial anisotropy of dog carotid artery: estimation of circumferential elastic modulus

Experiments were performed to study biaxial anisotropy in relaxed canine carotid arteries subjected to a wide range of longitudinal lengths and transmural pressures. In order to encompass the range of vessel lengths which occurs in situ, 120 carotid arteries were studied at 20%, 40%, 60% and 80% extension relative to retracted vessel length. These studies were performed in systematically randomized order. At each length, the vessels were pressurized in steps up to 200 mmHg transmural pressure, or until the traction force fell to zero. Results showed that longitudinal extension markedly increased the longitudinal elastic modulus, but had only a slight effect on the circumferential modulus. At physiological pressures, the vessels were nearly isotropic at about 70% longitudinal extension, but were anisotropic at shorter lengths. Estimates of the anisotropic circumferential modulus by a number of simplified methods revealed that use of a 'pressure-elastic modulus' (Ep) underestimated the anisotropic modulus by 80%, but was extremely consistent. Therefore when suitably corrected, Ep could be used to reliably estimate the anisotropic modulus of carotid arteries over a wide range of pressures and vessel lengths.     

Effect of variations in pressure and flow on the geometry of isolated canine carotid arteries

A study is described in which the effects of hemodynamics on arterial geometry are investigated in vitro. A novel perfusion apparatus is employed to deliver pulsatile flow through excised canine carotid arteries under carefully controlled conditions. Data of perfused vessel diameter and arterial wall thickness are derived from the radial displacement of the pulsating vessel as measured using a scanning laser micrometer whose accuracy is determined to be 0.0125 mm (0.0005 in). The results of 30 perfusion experiments suggest that the hemodynamic variables of transmural pressure, pulse pressure and flow rate influence vessel size and radial strain. The physiologic implications of these findings are discussed.     

Local prevention of thrombosis in the dog carotid artery using magnetically concentrated erythrocytes loaded with aspirin

Thrombosis was induced in both canine carotid arteries by means of vascular wall flap inversion into their lumens. A red, completely occluding thrombus was formed inside the vessel 4 to 5 hours later. SmCo5 magnet was secured externally to one of the arteries. The constant magnetic field produced by the magnet had no influence on the clot formation. Autologous red cells loaded with ferromagnetic colloid compound and aspirin were administered intravenously through the hind paw route; total aspirin pool was 20 micrograms. Circulating magnetically-charged red cells have been earlier shown to concentrate in a canine artery in the constant magnet area. The administration of magnetically-charged red cells loaded with aspirin completely prevented arterial thrombosis in the magnet-supplied artery, having no detrimental effect on clot formation in the control artery.     

The microcirculation of cerebral arteries: a morphologic and morphometric examination of the major canine cerebral arteries

A morphologic and morphometric examination of the major cerebral blood vessels in the dog was carried out to determine whether there were vasa vasorum in these arteries and what features might be associated with them. True vasa vasorum confined to the media were not seen in any of the vessels examined. Microvessels confined to the adventitia, however, were found in the internal carotid and vertebral arteries but not in the basilar, middle cerebral, or anterior spinal arteries. Animal size, vessel size as determined by adventitial and medial area, and the number of smooth muscle cell lamellae were not associated with the presence of these adventitial vessels; they occurred only in arteries with both an intra- and extradural portion. It therefore appears that most canine cerebral arteries do not have vasa vasorum.     

An experimental study on the ultimate strength of the adventitia and media of human atherosclerotic carotid arteries in circumferential and axial directions

Atherosclerotic plaque may rupture without warning causing heart attack or stroke. Knowledge of the ultimate strength of human atherosclerotic tissues is essential for understanding the rupture mechanism and predicting cardiovascular events. Despite its great importance, experimental data on ultimate strength of human atherosclerotic carotid artery remains very sparse. This study determined the uniaxial tensile strength of human carotid artery sections containing type II and III lesions (AHA classifications). Axial and circumferential oriented adventitia, media and intact specimens (total=73) were prepared from 6 arteries. The ultimate strength in uniaxial tension was taken as the peak stress recorded when the specimen showed the first evidence of failure and the extensibility was taken as the stretch ratio at failure. The mean adventitia strength values calculated using the first Piola–Kirchoff stress were 1996±867 and 1802±703 kPa in the axial and circumferential directions respectively, while the corresponding values for the media sections were 519±270 and 1230±533 kPa. The intact specimens showed ultimate strengths similar to media in circumferential direction but were twice as strong as the media in the axial direction. Results also indicated that adventitia, media and intact specimens exhibited similar extensibility at failure, in both the axial and circumferential directions (stretch ratio 1.50±0.22). These measurements of the material strength limits for human atherosclerotic carotid arteries could be useful in improving computational models that assess plaque vulnerability.     

Mechanical characteristics of the canine thoracic duct: what are the driving forces of the lymph flow?

This study is designed to better understand the mode of lymph transport, particularly through the extrinsic pumping by external compression of the lymph vessel. The pressure-diameter relationship of lymphatic segments isolated from the canine thoracic duct was examined using a laser optical micrometer measurement system. Results revealed that the thoracic duct displayed a high extensibility or compliance in the physiological pressure range, yet became progressively less so with increasing internal pressure. The calculated incremental circumferential modulus of the thoracic duct under physiological pressure (range of 2 to 6 cm H2O) showed values ranging from 1.2 x 10(4) to 3.61 x 10(5) dyn/cm2. At a pressure of 35 cm H2O, the modulus reached a limiting value of approximately 6.0 x 10(6) dyn/cm2. In the physiological pressure range, the relative wall thickness (h/R0) of the canine thoracic duct was approximately 3.5%, which was much lower than that reported for canine arterial segments and similar in value to that of the canine jugular vein. In conclusion, the pressure-diameter curve of the canine thoracic duct was shown to resemble that of venous vessels. However, the circumferential elastic modulus of the thoracic duct wall was lower than the moduli of veins, proving that lymphatics are more compliant than veins. This suggests lymph flow in the thoracic duct may be better promoted by external compression of the lymphatic vessel.     

Experimental determination of wall shear rate in canine carotid arteries perfused in vitro

The mathematical model of Hung (Tsai and Hung, 1984) is employed to determine the wall shear rate acting on canine carotid arteries perfused in vitro. Model equations for pulsatile flow in a deformable vessel are coupled with experimental data of dynamic pressure drop, flow rate, vessel radius and radial wall motion. Derived quantities, e.g. velocity profiles and wall shear, are obtained for vessels exposed to 'normotensive' hemodynamics, 'hypertension' simulations and perfusions in which the compliance of the vessel wall is deliberately altered. Our results indicate that wall shear varies markedly as a function of the hemodynamic environment. The effects of vessel radius vs flow rate on the development of wall shear are also demonstrated. It is found that convective processes correlate with the magnitude of wall shear in the 'hypertension' simulations. The present findings and complementary published data may explain, at least in part, the variations in vessel wall transport and endothelial cell biology we observe as a function of the hemodynamic environment. For example we have documented that the exposure of canine carotids to 'hypertensive' (vs 'normotensive') hemodynamics is associated with an increased flux of lipoproteins (LDL) into the intima and luminal media. Alternations in wall compliance, on the other hand, profoundly influence endothelial shape, orientation and cytoskeletal array.     

自发性高血压大鼠脑动脉心钠素受体分布的计量学研究

用软脑膜铺片技术,兔疫组织化学方法及全自动图像分析仪对１７周龄自发性高血压大鼠脑血管床心钠素受体分布密度进行研究、结果表明,自发性高血压大鼠脑小动脉及细动脉壁上心钠素受体分布密度明显低于正常血压大鼠,Ｐ＜０．０１。此外,在细小动脉分叉部位心钠素受体分布密度增加,而自发性高血压大鼠中其分叉部位的受体密度明显低于正常血压大鼠。从实验结果显示,我们试用的软脑膜铺片技术显然弥补了组织切片中从血管横断面观察心钠素受体分布的局限性,清楚地展现了整个血管床心钠素受体分布特征。根据实验结果提示这些阻力性动脉心钠素受体密度减少与细小动脉舒血管反应减弱,外周阻力增加,血压升高有着明显的关系;尤其是对调节外周循环血量和外周阻力充当闸门作用的细小动脉分叉部位,心钠素受体密度降低这一特征在高血压发生机制中可能起着重要作用。     

Experimental determination of mechanical shear stress about an anastomotic junction

The present study is undertaken to determine whether the elastic tube model originally developed by Kuchar and Ostrach (Biomedical Fluid Mechanics Symposium, pp. 45-69, 1966) accurately provides a first approximation of the biomechanics of the anastomotic junction. The experimental protocol involves the use of canine carotid arteries as the host vessel and several graft materials including autogenous and prosthetic substitutes. The host artery-graft combinations are perfused in vitro in a pulsatile perfusion apparatus which simulates the natural hemodynamic environment. This apparatus provides accurate dynamic measurements of radial wall motion (measured at various longitudinal increments), associated pressures and rates of fluid flow. These data are then applied to the theoretical model for calculation of anastomotic induced bending stresses. The results indicate that the predictions derived from the elastic model consistently overestimate the measured radial change adjacent to the anastomotic junction. As a result shear stresses based on elastic theory deviate from values derived from a numerical curve fit to the experimental data.     

Magnesium supplementation and deoxycorticosterone acetate--salt hypertension: effect on arterial mechanical properties and on activity of endothelin-1

The aim of this study was to show whether the decrease in blood pressure induced by Mg supplementation in deoxycorticosterone acetate - salt (DOCA-salt) hypertensive rats is associated with mechanical modifications of blood vessels and (or) changes in tissular production and (or) vasoconstrictor activity to endothelin-1. DOCA-salt treatment increased blood pressure, media thickness, cross-sectional area, and lumen diameter of carotid arteries. Distensibility and incremental elastic modulus versus stress were not altered in carotid arteries, suggesting that the DOCA-salt vessel wall adapts structurally to preserve its blood pressure buffering capacity. Magnesium supplementation attenuated DOCA-salt hypertension. In comparison with normotensive rats, systolic, mean, and pulse pressures were higher whereas diastolic pressure was not different in Mg-supplemented DOCA-salt rats. Magnesium supplementation did not significantly modify the elastic parameters of carotid arteries. In resistance mesenteric arteries, DOCA-salt hypertension induces an inward hypertrophic remodeling. Magnesium supplementation attenuates wall hypertrophy and increases lumen diameter to the normotensive diameter, suggesting a decrease in peripheral resistance. Magnesium supplementation normalizes the altered vasoconstrictor activity of endothelin-1 in mesenteric arteries and attenuates endothelin-1 overproduction in kidney, left ventricle, and aorta of DOCA-salt rats. These findings suggest that Mg supplementation prevents blood pressure elevation by attenuating peripheral resistance and by decreasing hypertrophic effect of endothelin-1 via inhibition of endothelin-1 production.     

Energy dissipation and pulse wave attenuation in the canine carotid artery

This paper presents methods for calculating, for a segment of artery in vivo, (1) viscous and viscoelastic energy dissipation as a function of time, and (2) the viscous and viscoelastic components of the frequency-dependent attenuation coefficient. The calculations require measurement of arterial diameter and of intra-arterial pressure and flow-rate at two sites along the vessel. Viscous energy dissipation is calculated from the radius-dependent velocity shear in the lumen given by linear theory from the pressure measurements. The attenuation coefficient for a given harmonic of heart rate is calculated as half the sum of the viscous and viscoelastic components at that frequency of the energy dissipated per unit length by forwardtravelling waves, divided by the forward-wave flow work input to the segment at that frequency. Measurements in canine carotid arteries indicate that wall viscoelasticity contributes relatively little to energy dissipation per cardiac cycle and pulse wave attenuation.     

Analysis of the timing parameters of blood flow in the carotid basin arteries of hypertensive patients

Vascular duplex ultrasound study with simultaneous ECG recording was performed to estimate the timing parameters of blood flow in the common carotid, internal carotid, and middle cerebral arteries in patients with grades 1 and 2 arterial hypertension. There was an increase in the blood flow acceleration phase index in the common carotid and middle cerebral arteries and a reduction in the systolic phase index in the internal carotid arteries. There were correlations of phasic blood flow parameters in the extra- and intracranial arteries with age and lipidogram readings.     

Biomechanics of the venous wall under simulated arterial conditions

The failure of vein graft conduits implanted in the arterial circulation has been hypothesized to occur in part due to the exposure of the graft to altered biomechanical and fluid shearing forces. In the present study, these forces are characterized for canine internal jugular veins (IJV) exposed to realistic arterial flow dynamics. Freshly excised vein segments were mounted into a pulsatile perfusion apparatus and exposed to arterial flow conditions (P = 115/75 mmHg and Q = 110 ml min-1) for 2 h. Dynamic measurements of intraluminal pressure and flow rate and vessel wall radial distension were acquired to accurately quantitate the incremental modulus of elasticity; hoop, axial and radial wall stresses; and fluid shearing forces within the vessel. Identical measurements were performed on canine carotid arteries (CCA) to serve as a comparison. Under arterial conditions, IJV segments demonstrated a significant elevation (p less than 0.05) over the CCA in the incremental elasticity modulus, along with a corresponding elevation in hoop and axial wall stresses. Additionally the average wall shearing rate to which the IJV endothelial surface was exposed was a factor of six less than that observed in the CCA. These results are discussed in relationship to the clinical situation of vein graft adaptation to arterial hemodynamics.     

Molecular characterization of feline infectious peritonitis virus strain DF-2 and studies of the role of ORF3abc in viral cell tropism

The full-length genome of the highly lethal feline infectious peritonitis virus (FIPV) strain DF-2 was sequenced and cloned into a bacterial artificial chromosome (BAC) to study the role of ORF3abc in the FIPV-feline enteric coronavirus (FECV) transition. The reverse genetic system allowed the replacement of the truncated ORF3abc of the original FIPV DF-2 genome with the intact ORF3abc of the canine coronavirus (CCoV) reference strain Elmo/02. The in vitro replication kinetics of these two viruses was studied in CrFK and FCWF-4 cell lines, as well as in feline peripheral blood monocytes. Both viruses showed similar replication kinetics in established cell lines. However, the strain with a full-length ORF3 showed markedly lower replication of more than 2 log(10) titers in feline peripheral blood monocytes. Our results suggest that the truncated ORF3abc plays an important role in the efficient macrophage/monocyte tropism of type II FIPV.     

Effects of hypoxia on contractility of isolated fetal lamb cerebral arteries

We studied the contractile properties of isolated cerebral arteries in near term fetal lambs, as well as the magnitudes and rates of relaxation during moderate hypoxia. Paired 5-mm segments of basilar, middle cerebral, posterior communicating, and common carotid arteries were suspended in a temperature controlled bath and isometric tension measured during 122 mM K(+)-induced contractions. In one vessel of each pair hypoxia was imposed by switching the bubbling gas from 95% O2 + 5% CO2 to 95% N2 + 5% CO2 4 minutes into a K+ contraction, thus lowering the bath PO2 to approximately 15 Torr. After 15 min exposure to hypoxia the middle cerebral artery had relaxed 61%, the posterior communicating 46%, the basilar 44%, and the common carotid only 18% compared to normoxic controls. All cerebral arteries relaxed relatively rapidly (relaxation rates of 42-45 x 10(-4) s-1), whereas the common carotid relaxed slowly (20 x 10(-4) sec-1). The data indicate that these cerebral arteries play an important role in regulating blood flow responses during hypoxemia in intact fetuses.     

Papaverine effects on PGI2 and TXA2 release from the canine vascular wall.

Operative manipulation of blood vessels might lead to spasm, thereby destroying the endothelial cell function: the spasm can be prevented by the vasodilator papaverine. To study if this was mediated via the prostanoid pathway the following investigation was undertaken: canine jugular veins and carotid arteries were dissected with or without papaverine. Vessel segments were then perfused with Hank's balanced salt solution for five times 15 min. Prostacyclin was measured as the stable degradation product 6-keto-PGF1 alpha and thromboxane as TXB2, by radioimmunoassay. Control arterial segments' 6-keto-PGF1 alpha release was initially 129.5 + 20.1 pg/mm2/15 min, and 29.7 + 10.4 after 60 min (p less than 0.05 vs initial value) and responded to arachidonic acid (AA) with an increase to 139.2 +/- 23.1 pg/mm2/15 min (p less than 0.05). Segments treated with papaverine had the same release as the controls. In venous segments there was a lower initial release (p less than 0.05) from segments given papaverine than from controls, but this was more likely an effect of papaverine on the assay. There was no difference in release of prostacyclin from segments given papaverine in the perfusate compared to controls when using 125I tracer. When using 3H tracer including absorption of free antigen to dextran coated charcoal, papaverine displaced the free tracer giving artificially low values. There was no effect of papaverine given intraoperatively on the TXB2 release, neither from arteries nor from veins. In another experiment the vessel wall tension was examined and the cyclooxygenase inhibitor diclofenac did not inhibit the vasodilating effect of papaverine.(ABSTRACT TRUNCATED AT 250 WORDS)     

Experimental determination of wall shear rate in canine carotid arteries perfused in vitro

The mathematical model of Hung (Tsai and Hung, 1984) is empolyed to determine the wall shear rate acting on canine carotid arteries perfused in vitro. Model equations for pulsatile flow in a deformable vessel are coupled with experimental data of dynamic pressure drop, flow rate, vessel radius and radial wall motion. Derived quantities, e.g. velocity profiles and wall shear, are obtained for vessels exposed to ‘normotensive’ hemodynamics, ‘hypertension’ simulations and perfusions in which the compliance of the vessel wall is deliberately altered. Our results indicate that wall shear varies markedly as a function of the hemodynamic environment. The effects of vessel radius vs flow rate on the development of wall shear are also demonstrated. It is found that convective processes correlate with the magnitude of wall shear in the ‘hypertension’ simulations.The present findings and complementary published data may explain, at least in part, the variations in vessel wall transport and endothelial cell biology we observe as a function of the hemodynamic environment. For example we have documented that the exposure of canine carotids to ‘hypertensive’ (vs ‘normotensive’) hemodynamics is associated with an increased flux of lipoproteins (LDL) into the intima and luminal media. Alternations in wall compliance, on the other hand, profoundly influence endothelial shape, orientation and cytoskeletal array.