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Hydraulic expansion facilitates remodeling of arteriovenous fistulas without increasing venous intimal hyperplasia in rabbits

Wanjun Ren
Wanjun Ren
, 
Jiyuan Niu
Jiyuan Niu
, 
Yuejuan Du
Yuejuan Du
 and 
Huili Jiang
Huili Jiang
   | Oct 29, 2021
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Article Category: Original article
Published Online: Oct 29, 2021
Page range: 223 - 232
DOI: https://doi.org/10.2478/abm-2021-0028
Keywords
© 2021 Wanjun Ren et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Background

An arteriovenous fistula (AVF) is considered essential for chronic hemodialysis.

Objective

To determine the effects of hydraulic expansion on the intimal hyperplasia of an AVF.

Methods

We divided 12 healthy male New Zealand white rabbits into a control group (vein without special handling and direct anastomosis with an artery, n = 6) and a hydraulic expansion group (vein dilated by hydraulic pressure before anastomosis, n = 6). Histopathomorphology was examined with hematoxylin and eosin staining and immunohistochemistry. Analysis of covariance (ANCOVA) was used to compare the data between the groups.

Results

Immediately and 1 day after surgery, the diameter of the fistula vein in rabbits in the hydraulic expansion group was significantly larger than it was in the control group (P = 0.02 and 0.03 respectively), but not on subsequent days. After hydraulic expansion and before construction of the fistula, the wall of vein was noticeably thinner on macroscopic observation, and the anterior and posterior walls were indistinguishable. At 3 weeks after surgery in the hydraulic expansion group, cells in the vein wall were disordered, there were fewer elastic fibers, tissues from the endothelium to tunica externa were less dense, and there was less extracellular matrix than in the control group. Expression of connective tissue growth factor in the hydraulic expansion group was significantly less than that in the control group (P = 0.01). No differences were found in intimal thickness or immunohistochemistry scores for transforming growth factor-β1 between the groups.

Conclusion

Hydraulic expansion did not increase intimal hyperplasia of an AVF, but facilitates remodeling of AVFs in rabbits.
eISSN:
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Language:
English
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