This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

An endothelin type A receptor antagonist inhibits neointimal hyperplasia and increases luminal area in porcine vein grafts. BJS 2001; 88: 602-602.

Published: 6th December 2002

Authors: R. A. Bulbulia, F. C. T. Smith, P. M. Lamont, R. N. Baird, G. D. Angelini, J. Y. Jeremy et al.

Background

Neointimal hyperplasia is responsible for the majority of cases of vein graft failure. To date, no pharmacological intervention has proved successful in preventing this process in humans. Endothelin (ET) 1 is a potent vasoconstrictor and promotes the proliferation of vascular smooth muscle cells in vitro. The authors have shown previously that porcine vein grafts contain high levels of ET‐1 and ET type A (ET_A) receptor subtypes. The aim was to investigate the effect of an ET_A receptor antagonist, BSF 302146, on luminal area and graft wall dimensions in a porcine model of arteriovenous bypass grafting.

Method

Bilateral saphenous vein–carotid artery interposition grafting was performed in two groups of Large White pigs (26–32 kg; n = 5 per group). BSF 302146 (10 mg kg⁻¹ day⁻¹) was administered orally to animals in group 1; group 2 animals acted as controls. After 4 weeks the grafts were explanted and pressure‐fixed ex vivo. Histological sections were obtained and graft dimensions assessed by means of computer‐aided planimetry.

Results

BSF 302146 significantly reduced both neointimal hyperplasia and medial thickening, and increased luminal area by 77 per cent.

Control
BSF 302146

Luminal area (mm²)
37·6(2·2)
66·7(3·9)*

Neointimal thickness (mm)
0·15(0·009)
0·11(0·004)*

Medial thickness (mm)
0·32(0·011)
0·25(0·014)

Values are mean(s.e.m.); n = 10.

Conclusion

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