Early healing after carotid endarterectomy: Effect of high- and low-dose aspirin on thrombosis and early neointimal hyperplasia in a nonhuman primate.

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Presentation transcript:

Early healing after carotid endarterectomy: Effect of high- and low-dose aspirin on thrombosis and early neointimal hyperplasia in a nonhuman primate model Harry L. Bush, M.D., Joseph A. Jakubowski, Ph.D., Joanna M. Sentissi, M.D. Journal of Vascular Surgery Volume 7, Issue 2, Pages 275-283 (February 1988) DOI: 10.1016/0741-5214(88)90146-2 Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Schematic outline of the experimental design. The control monkeys received only vehicle (orange juice) before the endarterectomy. The LDA group received the appropriate dose of aspirin for at least 2 weeks before operation and the morning of surgery. The HDA monkeys received their aspirin for at least 2 days before operation and the morning of surgery. After the endarterectomy, all three groups continued their specific treatment regimen until vessel excision 6 weeks later. The three experimental groups had platelet functions monitored before entering the study, at the time of surgery, and at the time of vessel excision. Six weeks after the carotid endarterectomy, the arteries were assessed for patency and morphologic findings. Journal of Vascular Surgery 1988 7, 275-283DOI: (10.1016/0741-5214(88)90146-2) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Cross-sectional areas (mm2 ± SEM) of the neointimal hyperplasia in the endarterectomized arteries from control, LDA, and HDA groups at 6 weeks. The HDA did not show any benefit when compared with the control monkeys. In contrast, LDA significantly protected the endarterectomized artery from developing neointimal hyperplasia (p < 0.05). Journal of Vascular Surgery 1988 7, 275-283DOI: (10.1016/0741-5214(88)90146-2) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Cross-sectional areas (mm2 ± SEM) of the entire endarterectomized vessel from the control, LDA, and HDA groups. The vessels in the three groups did not differ significantly, although the LDA group tended to have the largest overall diameter. Vasospasm did not appear to play a role at 6 weeks after endarterectomy. Journal of Vascular Surgery 1988 7, 275-283DOI: (10.1016/0741-5214(88)90146-2) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Photomicrograph of the area around the arteriotomy closure showing the vasa vasorum (VV) clustered at the suture line (S) and the neointimal hyperplasia (NIH) on the luminal side of the arteriotomy closure. M = residual media. The section is stained with an elastic stain (Verhoeff-van Gieson). (Original magnification × 100.) Journal of Vascular Surgery 1988 7, 275-283DOI: (10.1016/0741-5214(88)90146-2) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Photomicrograph of an entire cross section of an endarterectomized segment showing the eccentric nature of the neointimal hyperplasia at and adjacent to the arteriotomy. The section is stained with an elastic stain (Verhoeff—van Gieson). (Original magnification × 10.) Journal of Vascular Surgery 1988 7, 275-283DOI: (10.1016/0741-5214(88)90146-2) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions