Low wall shear stress predicts subsequent development of wall hypertrophy in lower limb bypass grafts
File(s)
Published version
Author(s)
Type
Journal Article
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 (1e2 weeks) and at follow-up (9e12 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 IMTincreasing sharply at lower levels ofWSS (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 lowwall shear stress in the development ofmyointimal hyperplasia.
Version
Published version
Date Issued
2009
Citation
Artery Research, 2009, 3 (1), pp.32-38
ISSN
1872-9312
Publisher
Elsevier
Start Page
32
End Page
38
Journal / Book Title
Artery Research
Volume
3
Issue
1
Copyright Statement
© 2009 Association forResearch into Arterial Structure and Physiology
Source Volume Number
3