Abstract
Background: Intimal hyperplasia has been historically associated with improper venous remodeling and stenosis after creation of an arteriovenous fistula. Recently, however, we showed that intimal hyperplasia by itself does not explain the failure of maturation of 2-stage arteriovenous fistulas. We seek to evaluate whether intimal hyperplasia plays a role in the development of focal stenosis of an arteriovenous fistula. Methods: This study compares intimal hyperplasia lesions in stenotic and nearby nonstenotic segments collected from the same arteriovenous fistula. Focal areas of stenosis were detected in the operating room in patients (n = 14) undergoing the second-stage vein transposition procedure. The entire vein was inspected, and areas of stenosis were visually located with the aid of manual palpation and hemodynamic changes in the vein peripheral and central to the narrowing. Stenotic and nonstenotic segments were documented by photography before tissue collection (14 tissue pairs). Intimal area and thickness, intima-media thickness, and intima to media area ratio were measured in hematoxylin and eosin stained cross-sections followed by pairwise statistical comparisons. Results: The intimal area in stenotic and nonstenotic segments ranged from 1.25 to 11.61 mm2 and 1.29 to 5.81 mm2, respectively. There was no significant difference between these 2 groups (P = .26). Maximal intimal thickness (P = .22), maximal intima-media thickness (P = .13), and intima to media area ratio (P = .73) were also similar between both types of segments. Conclusion: This preliminary study indicates that postoperative intimal hyperplasia by itself is not associated with the development of focal venous stenosis in 2-stage fistulas. (Surgery 2017;160:XXX-XXX.).
| Original language | English (US) |
|---|---|
| Journal | Surgery (United States) |
| DOIs | |
| State | Accepted/In press - Jan 1 2017 |
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ASJC Scopus subject areas
- Surgery
Cite this
Similar degree of intimal hyperplasia in surgically detected stenotic and nonstenotic arteriovenous fistula segments : A preliminary report. / Duque, Juan C.; Tabbara, Marwan; Martinez, Laisel; Paez, Angela; Selman, Guillermo; Salman, Loay; Velazquez, Omaida C; Vazquez-Padron, Roberto I.
In: Surgery (United States), 01.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Similar degree of intimal hyperplasia in surgically detected stenotic and nonstenotic arteriovenous fistula segments
T2 - A preliminary report
AU - Duque, Juan C.
AU - Tabbara, Marwan
AU - Martinez, Laisel
AU - Paez, Angela
AU - Selman, Guillermo
AU - Salman, Loay
AU - Velazquez, Omaida C
AU - Vazquez-Padron, Roberto I
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Intimal hyperplasia has been historically associated with improper venous remodeling and stenosis after creation of an arteriovenous fistula. Recently, however, we showed that intimal hyperplasia by itself does not explain the failure of maturation of 2-stage arteriovenous fistulas. We seek to evaluate whether intimal hyperplasia plays a role in the development of focal stenosis of an arteriovenous fistula. Methods: This study compares intimal hyperplasia lesions in stenotic and nearby nonstenotic segments collected from the same arteriovenous fistula. Focal areas of stenosis were detected in the operating room in patients (n = 14) undergoing the second-stage vein transposition procedure. The entire vein was inspected, and areas of stenosis were visually located with the aid of manual palpation and hemodynamic changes in the vein peripheral and central to the narrowing. Stenotic and nonstenotic segments were documented by photography before tissue collection (14 tissue pairs). Intimal area and thickness, intima-media thickness, and intima to media area ratio were measured in hematoxylin and eosin stained cross-sections followed by pairwise statistical comparisons. Results: The intimal area in stenotic and nonstenotic segments ranged from 1.25 to 11.61 mm2 and 1.29 to 5.81 mm2, respectively. There was no significant difference between these 2 groups (P = .26). Maximal intimal thickness (P = .22), maximal intima-media thickness (P = .13), and intima to media area ratio (P = .73) were also similar between both types of segments. Conclusion: This preliminary study indicates that postoperative intimal hyperplasia by itself is not associated with the development of focal venous stenosis in 2-stage fistulas. (Surgery 2017;160:XXX-XXX.).
AB - Background: Intimal hyperplasia has been historically associated with improper venous remodeling and stenosis after creation of an arteriovenous fistula. Recently, however, we showed that intimal hyperplasia by itself does not explain the failure of maturation of 2-stage arteriovenous fistulas. We seek to evaluate whether intimal hyperplasia plays a role in the development of focal stenosis of an arteriovenous fistula. Methods: This study compares intimal hyperplasia lesions in stenotic and nearby nonstenotic segments collected from the same arteriovenous fistula. Focal areas of stenosis were detected in the operating room in patients (n = 14) undergoing the second-stage vein transposition procedure. The entire vein was inspected, and areas of stenosis were visually located with the aid of manual palpation and hemodynamic changes in the vein peripheral and central to the narrowing. Stenotic and nonstenotic segments were documented by photography before tissue collection (14 tissue pairs). Intimal area and thickness, intima-media thickness, and intima to media area ratio were measured in hematoxylin and eosin stained cross-sections followed by pairwise statistical comparisons. Results: The intimal area in stenotic and nonstenotic segments ranged from 1.25 to 11.61 mm2 and 1.29 to 5.81 mm2, respectively. There was no significant difference between these 2 groups (P = .26). Maximal intimal thickness (P = .22), maximal intima-media thickness (P = .13), and intima to media area ratio (P = .73) were also similar between both types of segments. Conclusion: This preliminary study indicates that postoperative intimal hyperplasia by itself is not associated with the development of focal venous stenosis in 2-stage fistulas. (Surgery 2017;160:XXX-XXX.).
UR - http://www.scopus.com/inward/record.url?scp=85037570006&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85037570006&partnerID=8YFLogxK
U2 - 10.1016/j.surg.2017.10.038
DO - 10.1016/j.surg.2017.10.038
M3 - Article
C2 - 29241989
AN - SCOPUS:85037570006
JO - Surgery (United States)
JF - Surgery (United States)
SN - 0039-6060
ER -