Artery Research

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Volume 3, Issue 1, February 2009, Pages 32 - 38

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

Authors
Mark Jacksona, Nigel B. Woodb, *, Shunzhi Zhaob, Alexander Augstb, John H. Wolfec, Wladyslaw M.W. Gedroycd, Alun D. Hughesa, Simon A.McG. Thoma, Xiao Y. Xub
aNHLI Division, International Centre for Circulatory Health, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
bDepartment of Chemical Engineering, Imperial College London, London SW7 2AZ, UK
cDepartment of Vascular Surgery, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
dDivision of Clinical Sciences, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
*Corresponding author. Tel.: +44 20 7594 1168. E-mail address: n.wood@imperial.ac.uk (N.B. Wood).
Corresponding Author
Nigel B. Wood
Received 9 October 2008, Revised 17 December 2008, Accepted 6 January 2009, Available Online 6 February 2009.
DOI
10.1016/j.artres.2009.01.001How to use a DOI?
Keywords
Femoral vein graft; Computational modelling; Wall shear stress; Intima-media thickening; Non-linear relationship
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 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.

Copyright
© 2009 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

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<Previous Article In Issue
Next Article In Issue>
Journal
Artery Research
Volume-Issue
3 - 1
Pages
32 - 38
Publication Date
2009/02/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2009.01.001How to use a DOI?
Copyright
© 2009 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Mark Jackson
AU  - Nigel B. Wood
AU  - Shunzhi Zhao
AU  - Alexander Augst
AU  - John H. Wolfe
AU  - Wladyslaw M.W. Gedroyc
AU  - Alun D. Hughes
AU  - Simon A.McG. Thom
AU  - Xiao Y. Xu
PY  - 2009
DA  - 2009/02/06
TI  - Low wall shear stress predicts subsequent development of wall hypertrophy in lower limb bypass grafts
JO  - Artery Research
SP  - 32
EP  - 38
VL  - 3
IS  - 1
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2009.01.001
DO  - 10.1016/j.artres.2009.01.001
ID  - Jackson2009
ER  -