CELL INJURY IN VASCULAR SURGERY. THE INTIMAL HYPERPLASTIC RESPONSE

T. Zubilewicz*, E. Allaire, J. Wronski*, P. Desgranges, J.P. Becquemin, D. Melliere
Division of Vascular Surgery, University of Paris, Creteil, France;
* Departement of Vascular Surgery Medical Academy, Lublin, Poland

Arterial reconstructions fail because of technical unperfect on, restenosis, or progression of atherosclerosis. The incidence of this unfavorable outcome at two years is 30% after femoropopliteal revascularization with autologous saphenous vein and 40-50% synthetic grafts and 20-50% after transluminal angioplasty of superficial femoral artery and iliac artery. Anatomopathologic examinations of failures show intimal thickening, luminal narrowing or thrombosis. Intimal hyperplasia is the predominant mechanism of long term failure. The biology of intimal hyperplasia is extensively studied. The understanding of this biology might allow surgeons to develop a pharmacology aimed to improve long term results of arterial surgery.

P.17-24

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