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Circulation, Vol 55, 163-169, Copyright © 1977 by American Heart Association
BH Bulkley and GM Hutchins
Intimal thickening of uncertain cause has been noted in saphenous vein
bypass grafts. To study the development of these changes, 97 vein grafts in
55 autopsied patients were examined by angiography and histology.
Significant alterations in the grafts were confined to the intima and
included thin layers of circumferential thrombus, concentric fibrous plaque
and occlusive thrombus with organization. Circumferential nonocclusive
intimal thrombus was present in 36 (73%) postoperative patent grafts.
Concentric fibrous plaque, found in all twelve patent late grafts, showed
changes characteristic of atheromata, including smooth muscle and foam
cells. Intimal fibroelastosis was absent in the grafts, indicating that
concentric plaque is not a simple response to increased pressure, or an
"arterialization" of the vein. The findings suggest that early appearing
concentric intimal thrombus is converted into fibrous plaque, and that this
early thrombus is a factor in the development of acclereated
"atherosclerosis" in saphenous vein bypass grafts.
ARTICLES
Accelerated "atherosclerosis". A morphologic study of 97 saphenous vein coronary artery bypass grafts
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