Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2006-12-7
pubmed:abstractText
The conventional endovascular aortic aneurysm procedure entails the placement of oversized introducer sheaths in relatively normal ileofemoral arteries to allow the delivery and deployment of endovascular prosthesis. Endoluminal manipulation with passage of oversized endoluminal devices can lead to endothelial denudation, resulting in impaired cellular function. The purpose of this study was to assess the time course of endothelial function with vasoreactivity following oversized endovascular sheath insertion ranging from 1 day to 16 weeks in normal porcine iliac arteries. Following oversized introducer sheath placement in bilateral iliac arteries, vasoreactivity was tested using both endothelium-dependent and -independent vasodilators. Intravascular ultrasonography showed a significant reduction in the luminal area at 12 and 16 weeks. This was similarly supported by morphometric analysis, which showed increased medial thickness with an elevated intima to media ratio at the same time course. Endothelium-dependent relaxation to bradykinin, calcium ionophore A23187, serotonin, and adenosine diphosphate all uniformly displayed attenuated endothelial dysfunction at all time points when compared with the control group. In contrast, endothelium-independent relaxation showed a decreased vasoresponsiveness at 4 weeks. In conclusion, this study underscored the detrimental and chronic endothelial dysfunction in a normal artery caused by oversized introducer sheath placement. Chronically impaired endothelial function may play a role leading to iliofemoral artery thrombosis or late occlusion, which were well-recognized adverse events following endovascular aneurysm procedures. Our study underscores the importance of appropriate patient selection to minimize potential sheath oversize and endograft device miniaturization to avoid vessel wall injury and maintain vasoreactivity.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1708-5381
pubmed:author
pubmed:issnType
Print
pubmed:volume
14
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
353-61
pubmed:meshHeading
pubmed-meshheading:17150156-Adenosine Diphosphate, pubmed-meshheading:17150156-Angiography, pubmed-meshheading:17150156-Angioplasty, pubmed-meshheading:17150156-Animals, pubmed-meshheading:17150156-Bradykinin, pubmed-meshheading:17150156-Calcimycin, pubmed-meshheading:17150156-Dose-Response Relationship, Drug, pubmed-meshheading:17150156-Endothelium, Vascular, pubmed-meshheading:17150156-Equipment Design, pubmed-meshheading:17150156-Iliac Artery, pubmed-meshheading:17150156-Models, Animal, pubmed-meshheading:17150156-Nitric Oxide, pubmed-meshheading:17150156-Organ Culture Techniques, pubmed-meshheading:17150156-Serotonin, pubmed-meshheading:17150156-Sus scrofa, pubmed-meshheading:17150156-Time Factors, pubmed-meshheading:17150156-Ultrasonography, Interventional, pubmed-meshheading:17150156-Vasodilation, pubmed-meshheading:17150156-Vasodilator Agents
pubmed:articleTitle
Chronically impaired endothelial vasoreactivity following oversized endovascular introducer sheath placement in porcine iliac arteries: implications for endovascular therapy.
pubmed:affiliation
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA. plin@bcm.edu
pubmed:publicationType
Journal Article, Research Support, N.I.H., Extramural