Abstract
To elucidate the mechanisms of localisation of intimal hyperplasia in anastomosed arteries, the effects of flow disturbances on the transport of lowdensity lipoproteins (LDLs) from the flowing blood to the wall of end-to-end anastomosed arteries, with and without a moderate stenosis, were studied theoretically by means of a computer simulation under the condition of steady flow. In an artery with moderate stenosis at the anastomotic junction and intimal thickening distal to it, we found that, owing to the water-permeable nature of the arterial wall, the surface concentration of LDL was elevated up to 20% higher than that of the bulk flow distal to the stenosis, where a recirculation zone was formed and wall shear stresses were low. In contrast to this, no significant elevation of surface concentration of LDLs occurred in another anastomosed vessel in which no stenosis was formed and no intimal thickening was observed. These results suggest that flowdependent concentration polarisation of LDLs plays a causative role in the localisation of anastomotic intimal hyperplasia in the human arterial system by locally elevating the surface concentration of LDLs, thus augmenting their uptake by endothelial cells.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Asakura, T., andKarino, T. (1990): ‘Flow patterns and spatial distribution of atherosclerotic lesions in human coronary arteries’,Circ. Res.,66, pp. 1045–1066
Bassiouny, H.S., White, S., Glagov, S., Choi, E., Giddens, D. P., andZarins, C. K. (1992): ‘Anastomotic intimal hyperplasia: mechanical injury or flow induced’,J. Vasc. Surg.,15, pp. 708–717
Baumann, D. S., Doblas, M., Daugherty, A., Sicard, G., andSchonfeld, G. (1994): ‘The role of cholesterol accumulation in prosthetic vascular graft anastomotic intimal hyperplasia’,J. Vasc. Surg.,19, pp. 435–445
Bratzler, B. L., Chisolm, G. M., Colton, C. K., Smith, K.A., andLees, R. S. (1977): ‘The distribution of labeled low-density lipoproteins across the rabbit thoracicin vivo’,Atherosclerosis,28, pp. 289–307
Brooks, A. N., andHughes, T. J. R. (1982): ‘Streamline upwind/Petrov-Galerkin formulations for convection dominated flow with particular emphasis on the incompressible Navier-Stokes equations’,Comput. Methods Appl. Mech. Eng.,32, pp. 199–259
Campeau, L. (2000): ‘Lipid lowering and coronary bypass graft surgery’,Curr. Opin. Cardiol.,15, pp. 395–399
Chuang, P. T., Cheng, H. J., Lin, S. J., Jan, K. M., Lee, M. M., andChien, S. (1990): ‘Macromolecular transport across arterial and venous endothelium in rats. Studies with Evans blue-albumin and horseradish peroxidase’,Arteriosclerosis,10, pp. 188–197
Clowes, A. W., Gown, A. M., Hanson, S. R., andReidy, M. A. (1985): ‘Mechanisms of arterial graft failure. 1. Role of cellular proliferation in early healing of PTFE prostheses’,Am. J. Pathol.,118, pp. 43–54
Deng, X., Marois, Y., How, T., Merhi, Y., King, M., Guidoin, R., andKarino, T. (1995): ‘Luminal surface concentration of lipoprotein (LDL) and its effect on the wall uptake of cholesterol by canine carotid arteries’,J. Vasc. Surg.,21, pp. 135–145, and22, pp. 9A and 648
Friedman, M. H., Henderson, J. M., Aukerman, J. A., andClingan, P. A. (2000): ‘Effect of periodic alterations in shear on vascular macromolecular uptake’,Biorheology,37, pp. 265–277
Fry, D. L. (1977): ‘Aortic Evans blue dye accumulation: its measurement and interpretation’,Am. J. Physiol.,232, (Heart Circ. Physiol.,1) pp. H204-H222
Gudoin, R., Couture, J., Assayed, F., andGosselin, C. (1988): ‘New frontiers of vascular grafting’,Int. Surg.,73, pp. 241–249
Hoff, H. F., andWagner, W. D. (1986): ‘Plasma low density lipoprotein accumulation in aortas of hypercholesterolemic swine correlates with modifications in aortic glycosaminoglycan composition’,Atherosclerosis,61, pp. 231–236
Hunninghake, D. B. (1998): ‘Is aggressive cholesterol control justified? Review of the post-coronary artery bypass graft trial’,Am. J. Cardiol.,82, pp. 45T-48T
Imparato, A. M., Bracco, A., Kim, G. E., andZeff, R. (1972): ‘Intimal and neointimal fibrous proliferation causing failure of arterial reconstructions’,Surgery,72, pp. 1007–1017
Ishibashi, H., Sunamura, M., andKarino, T. (1995): ‘Flow patterns and preferred sites of intimal thickening in end-to-end anastomosed vessels’,Surgery,117, pp. 409–420
Jo, H., Dull, R. O., Hollis, T. M., andTarbell, J. M. (1991): ‘Endothelial albumin permeability is shear dependent, time dependent, and reversible’,Am. J. Physiol.,260, pp. H1992-H1996
Karino, T., andMotomiya, M. (1983): ‘Flow visualization in isolated transparent natural blood vessel’,Biorheology,20, pp. 119–127
Kleinstreuer, C., Hyun, S., Buchanan, J. R. Jr., Longest, P. W., Archie, J. P. Jr., andTruskey, G. A. (2001): ‘Hemodynamic parameters and early intimal thickening in branching blood vessels’,Crit. Rev. Biomed. Eng.,29, pp. 1–64
Klyachkin, M. L., Davies, M. G., Svendsen, E., Kim, J. H., Massey, M. F., Barber, L., McCann, R. L., andHagen, P. O. (1993): ‘Hypercholesterolemia and experimental vein grafts: accelarated development of intimal hyperplasia and an increase in abnormal vasomotor function’,J. Surg. Res.,54, pp. 451–468
Ku, D. N., Giddens, D. P., Zarins, C. K., andGlagov, S. (1985): ‘Pulsatile flow and atherosclerosis in the human carotid bifurcation: positive correlation between plaque location and low oscillating shear stress’,Arteriosclerosis,5, pp. 293–302
Mii, S., Okadome, K., Onohara, T., Yamamura, S., andSugimachi, K. (1990): ‘Intimal thickening and permeability of arterial autogenous vein graft in a canine poor-runoff model: transmission electron microscopic evidence’,Surgery,108, pp. 81–89
Miller, J. H., Foreman, R. K., Ferguson, L., andFaris, I. (1984): ‘Interposition vein cuff for anastomosis of prosthesis to small artery’,Aust. N. Z. J. Surg.,54, pp. 283–285
Naiki, T., Sugiyama, H., Tashiro, R. andKarino, T. (1999): ‘Flowdependent concentration polarization of plasma proteins at the luminal surface of a cultured endothelial cell monolayer’,Biorheology,36, pp. 225–241
Pedersen, E. M., Qyre, S., Agerbaek, M., Kristensen, I. B., Ringgaard, S., Boesiger, P., and Paaske, W. P. (1999): ‘Distribution of early atherosclerotic lesions in the human abdominal aorta correlates with wall shear stresses measured in vivo’,Eur. J. Vasc. Endovasc. Surg.,18, pp. 328–333
Ross, R., andHarker, L. (1976): ‘Hyperlipidemia and atherosclerosis: chronic hyperlipidemia initiates and maintains lesions by endothelial cell desquamation and lipid accumulation’,Science,193, pp. 1094–1100
Sottiurai, V. S., Yao, J. S., Batson, R. C., Sue, S. L., Jones, R., andNakamura, Y. A. (1989): ‘Distal anastomotic intimal hyperplasia: histopathologic character and biogenesis’,Ann. Vasc. Surg.,3, pp. 26–33
Stary, H. C., Chandler, A. B., Glagov, S., Guyton, J. R., Insull, W., Jr., Rosenfeld, M. E., Schaffer, A., Schwarit, C. J., Wagner, W. D., andWissler, R. W. (1994): ‘A definition of initial, fatty streak, and intermediate lesions of atherosclerosis: a report from the committee on vascular lesions of the council on arteriosclerosis’,Arterioscler. Thromb.,14, pp. 840–856
Taylor, R. S., Loh, A., McFarland, R. J., Cox, M., andChester, J. F. (1992): ‘Improved technique for polytetrafluoroethylene bypass grafting: long-term results using anastomotic vein patches’,Br. J. Surg.,79, pp. 348–354
Tedgui, A., andLever, M. J. (1984): ‘Filtration through damaged and undamaged rabbit thoracic aorta’,Am. J. Physiol.,247, (Heart Circ. Physiol.,16), pp. H784-H791
Truskey, G. A., Roberts, W. L., Herrmann, R. A., andMalinauskas, R. A. (1992): ‘Measurement of endothelial permeability to125I-low density lipoproteins in rabbit arteries by use ofen face preparations’,Circ. Res.,71, pp. 883–897
Tyrrell, M. R., andWolfe, J. H. (1991): ‘New prosthetic venous collar anastomotic technique: combining the best of other procedures’,Br. J. Surg.,78, pp. 1016–1017
Vasile, K., Simionescu, M., andSimionescu, N. (1983): ‘Visualization of the binding, endocytosis, and transcytosis of low-density lipoprotein in the arterial endotheliumin situ’,J. Cell. Biol.,96, pp. 1677–1689
Wada, S., andKarino, T. (1999): ‘Theoretical study on flowdependent concentration polarization of low density lipoproteins at the luminal surface of a straight artery’,Biorheology,36, pp. 207–223
Wada, S., andKarino, T. (2002a): ‘Theoretical prediction of LDL concentration at the luminal surface of an artery with a multiple bend’,Ann. Biomed. Eng.,30, pp. 778–791
Wada, S., andKarino, T. (2002b) ‘Prediction of LDL concentration at the luminal surface of a vascular endothelium’,Biorheology,39, pp. 331–336
Wada, S., Kaichi, M., andKarino, T. (2001a): ‘Changes in water filtration velocity and wall structure of the rabbit common carotid artery after removal of the adventitia’,JSME Int. J., C44, pp. 996–1004
Wada, S., Koujiya, M., andKarino, T. (2001b): ‘The effect of creating a moderate stenosis on the localization of intimal thickening in the common carotid artery of the rabbit fed on a cholesterol-rich diet’,JSME Int. J. C44, pp. 1021–1030
Weinbaum, S., Tzeghai, G., Ganatos, P., Pfeffer, R., andChien, S. (1985): ‘Effect of cell turnover and leaky junctions on arterial macromolecular transport’,Am. J. Physiol.,248, pp. H945-H960
Zarins, C. K., Giddens, D. P., Bharadvaj, B. K., Sottiurai, V. S., Mabon, R. F., andGlagov, S. (1983): ‘Carotid bifurcation atherosclerosis: quantitative correlation of plaque localization with flow velocity profiles and wall shear stress’,Circ. Res.,53, pp. 502–514
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wada, S., Koujiya, M. & Karino, T. Theoretical study of the effect of local flow disturbances on the concentration of low-density lipoproteins at the luminal surface of end-to-end anastomosed vessels. Med. Biol. Eng. Comput. 40, 576–587 (2002). https://doi.org/10.1007/BF02345458
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02345458