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Eur J Cardiothorac Surg 2003;24:92-97
© 2003 Elsevier Science NL

Prophylactic gamma radiation of unaffected vein grafts failed to prevent vein graft disease in a chronic hypercholesterolemic porcine model

^a Clinic for Cardiac Surgery, Medical University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
^b Institute for Anatomy, University of Luebeck, Luebeck, Germany
^c Institute for Pharmacology, University of Luebeck, Luebeck, Germany
^d Institute for Radiation Therapy, University of Luebeck, Luebeck, Germany
^e Clinic for Anesthesiology, University of Luebeck, Luebeck, Germany

Received 23 December 2002; received in revised form 4 March 2003; accepted 17 March 2003.

^* Corresponding author. Tel.: +49-451-2108; fax: +49-451-2051
e-mail: janfelixchristiansen{at}gmx.de

Objective: The value of prophylactic brachytherapy on vein graft disease is unknown. Methods and results: Vein bypass grafts in 23 hypercholesterolemic pigs after ex vivo gamma irradiation of the vein grafts (10, 20, and 40 Gy) and 16 control veins were analyzed regarding: (1) expression of platelet-derived growth factor (PDGF-AA and -BB, ELISA); (2) smooth muscle cell (SMC) proliferation/cell death (double-immunohistochemistry Mib-1/TUNEL/SMC -actin); and (3) vessel wall dimensions. Planimetric data on vessel wall dimensions revealed no positive effect of gamma radiation on neointima formation and inner lumen diameter. On the contrary, vein grafts subjected to 40 Gy were significantly more likely to be occluded and to have reduced inner lumen and increased neointima formation. Radiation therapy had no effect on PDGF expression and SMC proliferation/cell death. The mean inner lumen diameter decreased as PDGF-AA expression increased. Conclusions: Prophylactic gamma radiation of unaffected vein grafts failed to prevent vein graft disease in a hypercholesterolemic porcine model. High-dose radiation (40 Gy) resulted in more frequent graft occlusion and vein sclerosis.

Key Words: Bypass • Veins • Atherosclerosis

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