Open Access Research article

Oversized vein grafts develop advanced atherosclerosis in hypercholesterolemic minipigs

Troels Thim16*, Mette Kallestrup Hagensen1, Arne Hørlyck2, Ludovic Drouet3, William P Paaske4, Hans Erik Bøtker5 and Erling Falk1

Author Affiliations

1 Atherosclerosis Research Unit, Department of Cardiology, Aarhus University Hospital and Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark

2 Department of Radiology, Aarhus University Hospital, Aarhus, Denmark

3 Institut des Vaisseaux et du Sang, Paris, France

4 Department Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark

5 Department Cardiology, Aarhus University Hospital, Aarhus, Denmark

6 Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark

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BMC Cardiovascular Disorders 2012, 12:24  doi:10.1186/1471-2261-12-24

Published: 31 March 2012

Abstract

Background

Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis.

Methods

An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were investigated 12-14 weeks later with ultrasound and angiograpy in vivo and microscopy post mortem.

Results

One minipig died during follow up (patent vein graft at autopsy), and one vein graft thrombosed early. In the remaining eight patent vein grafts, the mean (standard deviation) intima-media thickness was 712 μm (276 μm) versus 204 μm (74 μm) in the contralateral control internal jugular veins (P < .01). Advanced atherosclerotic plaques were found in three of four oversized vein grafts (diameter of graft > diameter of artery). No plaques were found in four non-oversized vein grafts (P < .05).

Conclusions

Our model of jugular vein graft in the common carotid artery of hypercholesterolemic minipigs displayed the components of human vein graft disease, i.e. thrombosis, intimal hyperplasia, and atherosclerosis. Advanced atherosclerosis, the main cause of late failure of human aortocoronary vein grafts was only seen in oversized grafts. This finding suggests that oversized vein grafts may have detrimental effects on patient outcome.