Luigi Pascarella, MD, Geert W. Schmid-Schönbein, PhD, John Bergan, MD

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Presentation transcript:

An animal model of venous hypertension: The role of inflammation in venous valve failure Luigi Pascarella, MD, Geert W. Schmid-Schönbein, PhD, John Bergan, MD Journal of Vascular Surgery Volume 41, Issue 2, Pages 303-311 (February 2005) DOI: 10.1016/j.jvs.2004.10.038 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 This diagram shows the location of the arteriovenous fistula and the femoral vein. Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 This diagram shows the principal measurements that were made on the fresh specimens. 1. Vein diameter at the valve annulus. 2. Valvular height. Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Edema of the limb ipsilateral to the arteriovenous fistula as shown here was regularly seen in the early postoperative period. Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 This graph shows progressively increasing reflux through the first valve distal to the arteriovenous fistula (P < .01 for the 21- and 42-day values and P < .05 for the 7-day group compared with the controls). Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 5 A, This graph illustrates progressive valve dilation caused by the high pressure early and venous wall weakness later (P < .01 at 21 and 42 days from the creation of the fistula). B, Progressive valve shortening is shown in this graph (P < .01 for the 21- and 42-day values compared with the controls). Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 6 A, At 21 days loss of tissue architecture is prominent. There is fibrosis of the media and fusion with the adventitia. The valve is present, and strong staining for MMP-2 is present in the media. (Transverse sections, mono-staining for MMP-2 with Nova-red background staining). B, At 42 days the valve has disappeared. There is still fibrosis of the media and fusion with the adventitia. MMP-2 staining is prominent. (Transverse sections, mono-staining for MMP-2 and Nova-red background staining.) Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 7 These figures are longitudinal sections of vein wall and valve leaflet double stained for MMP-2 and MMP-9 with Nova-red background staining. The control vein without arteriovenous fistula is on the left. 21-day specimen in the center shows MMP-9 staining of the intima, MMP-2 staining of the media, and the valve is present. The 42-day specimen (right) shows similar staining and absence of the valve. Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 8 MMP expression is prominent in the 21- and 42-day specimens (P < .01 compared with the controls and other groups). Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 9 MMP expression is bimodal and indicates early and progressive inflammation (P < .01 for the 1-, 21-, and 42-day values compared to the controls). Journal of Vascular Surgery 2005 41, 303-311DOI: (10.1016/j.jvs.2004.10.038) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions