Abstract
This study aimed to evaluate the inhibitory effect of pentoxifylline, a phosphodiesterase inhibitor on intimal hyperplasia (IH) and vascular smooth muscle cell proliferation in an anastomosis model of rabbit carotid artery (CA). Right CAs of 18 male New Zealand white rabbits were anastomosed under general anesthesia. After the surgical procedure, 18 rabbits were separated into three study groups, 6 in each. Group 1 (control group) did not receive any treatment. Group 2 and 3 were treated with 100 mg/kg/day subcutaneous pentoxifylline for 7 and 21 days, respectively. After 28 days, histopathological assessments and histomorphometric measurements were performed on the CA segments. In the histological sections, IH was less evident in the anastomosed vessel wall in pentoxifylline-treated groups than in Group 1. The mean luminal diameter (LD), luminal area (LA), intimal thickness (IT), and intima/media ratio (IMR) for Group 1 were 472.63 ± 13.28 μm, 301,973.33 ± 12,951.27 μm2, 200,844.67 ± 8,375.38 μm, and 0.52 ± 0.01, respectively. The LD and LA were significantly higher, and the IT and IMR were significantly lower for Group 2 and 3 compared with Group 1 (p 0.05). Subcutaneous pentoxifylline treatment, even for duration of only seven days decreases IH in arterial anastomosis sites in a rabbit CA anastomosis model. Key words: Pentoxifylline, vascular graft, anastomosis, carotid arteries.
Highlights
Reconstructive vascular surgery is a common intervention for the treatment of obstructive arterial disease that is less successful than expected due to the development of spontaneous thrombosis or restenosis after the surgery (Ducasse et al, 2003)
On the basis of current evidence on the antimitogenic effects of PTX in animal models, we aimed to evaluate the effects of PTX on intimal hyperplasia (IH) and vascular smooth muscle cell proliferation in an anastomosis model of the rabbit carotid artery (CA)
We believe that the anastomosis model is superior to balloon angioplasty which has been used in previous studies, in that it is more similar to injuries that may occur during vascular surgery because it affects all three layers of the vessel wall
Summary
Reconstructive vascular surgery is a common intervention for the treatment of obstructive arterial disease that is less successful than expected due to the development of spontaneous thrombosis or restenosis after the surgery (Ducasse et al, 2003). Pentoxifylline (PTX), a methylxanthine derivative, is a phosphodiesterase inhibitor with potent hemorheologic properties (Samlaska and Winfield 1994; Schönharting et al, 1988) It is used in the treatment of peripheral vascular disease, cerebrovascular disease, and a number of other conditions involving defective regional microcirculation (Ward and Clissold, 1987). It was shown that subcutaneous PTX treatment induced less proliferation within the vessel wall and increased lumen size after balloon angioplasty of the iliac artery of rabbits. It has a positive effect on vascular remodeling (Busk et al, 2008). We believe that the anastomosis model is superior to balloon angioplasty which has been used in previous studies, in that it is more similar to injuries that may occur during vascular surgery because it affects all three layers of the vessel wall
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