Pathological Analysis of Vascularization of the Arterialized Veins in Failed Arteriovenous Fistulae
Pathological Analysis of Vascularization of the Arterialized Veins in Failed Arteriovenous Fistulae
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发表时间：
2022
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通讯作者：
Dongmei Xu
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作者：
Qinlan Chen;Liming Liang;Ziheng Zhang;Jing Du;Lijun Tang;Wei Cao;Xianglei Kong;Dongmei Xu
Purpose: To assess venous wall vascularization and its correlation with neointimal hyperplasia (NIH) in failed arteriovenous.fistulae (AVFs)..Materials and Methods: A total of 43 uremic patients who underwent de novo AVF creation and 39 patients who.underwent reconstruction of failed fistulae were enrolled in the study. A 5–10-mm vein segment adjacent to the future fistula.creation or reconstruction site was surgically removed and assessed using histopathological analyses and stained by.immunohistochemistry to quantify vasa vasorum density (VVD)..Results: Both the intimal thickness (70.68 [28.81–99.54] vs 4.53 [2.69–7.30] μm, P < .001) and the intimal thickness-tomedial.thickness ratio (2.20 [0.77–4.36] vs 0.15 [0.10–0.30], P < .001) were higher in failed AVFs than in preaccess veins..CD31- and factor VIII–marked VVDs in both the intima (6.31 [1.62–12.53] vs 0.0 [0.0–0.0], P < .001; 7.82 [3.33–11.61] vs 0.0.[0.0–0.0], P < .001) and media (10.0 [7.59–12.95] vs 3.71 [2.44–4.87], P < .001; 8.33 [5.55–13.0] vs 3.57 [2.53–4.82], P < .001).as well as the intimal VVD:medial VVD ratio (0.67 [0.19–1.08] vs 0.0 [0.0–0.0], P < .001; 0.71 [0.39–1.14] vs 0.0 [0.0–0.0], P <..001) were significantly higher in failed AVFs than in preaccess veins. Moreover, there was a positive relationship between.the intimal VVD:medial VVD ratio and the intimal thickness:medial thickness ratio (P < .001). In addition, the vascular.endothelial cell growth factor A expression was higher in failed AVFs than in preaccess veins..Conclusions: Vascularization of the vessel wall was noticeably more developed in the arterialized veins, especially at the.NIH regions in failed AVFs.
