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  • Low wall shear stress predicts subsequent development of wall hypertrophy in lower limb bypass grafts

    Author(s)
    Jackson, Mark
    B. Wood, Nigel
    Zhao, Shunzhi
    Augst, Alexander
    H. Wolfe, John
    M.W. Gedroyc, Wladyslaw
    D. Hughes, Alun
    A.McG. Thom, Simon
    Y. Xu, Xiao
    Griffith University Author(s)
    Jackson, Mark J.
    Year published
    2009
    Metadata
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    Abstract
    Background Venous grafts commonly develop myointimal hyperplasia, which can lead to stenoses and, ultimately, with expression of adhesion molecules, lumenal occlusion. The aim of the present study was to investigate whether wall shear stress measured post-operatively would predict subsequent myointimal hypertrophy in lower limb venous bypass grafts. Methods Magnetic resonance imaging and ultrasound were performed in a cohort of patients following lower limb venous bypass graft surgery for peripheral arterial disease at baseline (1-2 weeks) and at follow-up (9-12 months). Wall shear stress was determined at baseline using ...
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    Background Venous grafts commonly develop myointimal hyperplasia, which can lead to stenoses and, ultimately, with expression of adhesion molecules, lumenal occlusion. The aim of the present study was to investigate whether wall shear stress measured post-operatively would predict subsequent myointimal hypertrophy in lower limb venous bypass grafts. Methods Magnetic resonance imaging and ultrasound were performed in a cohort of patients following lower limb venous bypass graft surgery for peripheral arterial disease at baseline (1-2 weeks) and at follow-up (9-12 months). Wall shear stress was determined at baseline using computational fluid dynamics techniques and intima-media thickness along the length of the graft was measured by ultrasound at baseline and follow up. Results Complete follow-up was possible in eight patients, in whom low wall shear stress at baseline predicted high intima-media thickness. The relationship between wall shear stress (WSS) and intima-media thickness (IMT) was curvilinear with IMT increasing sharply at lower levels of WSS (IMT >1.0 mm at <0.3 Pa). Conclusions Low wall shear stress is associated with subsequent increase in myointimal thickness in lower limb venous bypass grafts. This is believed to be the first prospective study in humans to demonstrate the relationship between low wall shear stress and myointimal thickening and indicates a likely causative role for low wall shear stress in the development of myointimal hyperplasia.
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    Journal Title
    Artery Research
    Volume
    3
    Issue
    1
    DOI
    https://doi.org/10.1016/j.artres.2009.01.001
    Subject
    Medical and Health Sciences not elsewhere classified
    Clinical Sciences
    Publication URI
    http://hdl.handle.net/10072/37898
    Collection
    • Journal articles

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