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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.

Figure 1

Surgical procedure. (A) Internal jugular vein, common carotid artery, and external jugular vein of rabbit. (B) Vein dilatated with hydraulic pressure. (C) Vein dilatated with hydraulic pressure (close-up). (D) Successfully constructed fistula.
Surgical procedure. (A) Internal jugular vein, common carotid artery, and external jugular vein of rabbit. (B) Vein dilatated with hydraulic pressure. (C) Vein dilatated with hydraulic pressure (close-up). (D) Successfully constructed fistula.

Figure 2

Histology. (A) Venous wall before dilation. (B) Venous wall after dilation. (C) Changes of fistula vein in control group 3 weeks after operation. (D) changes of fistula vein in hydraulic expansion group 3 weeks after operation (all panels HE staining, ×200; scale bars represent 50 μm). HE, hematoxylin and eosin.
Histology. (A) Venous wall before dilation. (B) Venous wall after dilation. (C) Changes of fistula vein in control group 3 weeks after operation. (D) changes of fistula vein in hydraulic expansion group 3 weeks after operation (all panels HE staining, ×200; scale bars represent 50 μm). HE, hematoxylin and eosin.

Figure 3

Expression of TGF-β1 immunoreactivity in vein (A) before surgery, (B) fistula vein in control group 3 weeks after surgery, (C) fistula vein in hydraulic expansion group 3 weeks after surgery. Expression of CTGF immunoreactivity in vein (D) before surgery, (E) fistula vein in control group 3 weeks after surgery, (F) fistula vein in hydraulic expansion group 3 weeks after surgery. (DAB staining of immunocomplexes, ×200; scale bars represent 50 μm). CTGF, connective tissue growth factor; DAB, diaminobenzidine; TGF-β1, transforming growth factor-β1.
Expression of TGF-β1 immunoreactivity in vein (A) before surgery, (B) fistula vein in control group 3 weeks after surgery, (C) fistula vein in hydraulic expansion group 3 weeks after surgery. Expression of CTGF immunoreactivity in vein (D) before surgery, (E) fistula vein in control group 3 weeks after surgery, (F) fistula vein in hydraulic expansion group 3 weeks after surgery. (DAB staining of immunocomplexes, ×200; scale bars represent 50 μm). CTGF, connective tissue growth factor; DAB, diaminobenzidine; TGF-β1, transforming growth factor-β1.

Diameter of fistula vein after AVF surgery in rabbits

Postoperative day Hydraulic expansion (n = 6)Diameter (mm) Control (n = 6)Diameter (mm) F P
Baseline (0) 4.34 ± 0.50 2.80 ± 0.57 6.79 0.02*
    1 4.02 ± 0.58 3.01 ± 0.18 7.87 0.03*
    2 3.92 ± 0.91 3.34 ± 0.26 0.97 0.53
    3 5.12 ± 1.30 4.36 ± 0.86 1.72 0.28
    7 4.93 ± 0.52 4.17 ± 0.51 1.94 0.22
    14 5.19 ± 1.04 4.18 ± 0.52 0.99 0.51
    21 4.52 ± 0.29 4.39 ± 0.28 0.95 0.52

Baseline data for rabbits in experimental and control groups.

Hydraulic expansion (n = 6) Control (n = 6)
Weight (kg) 2.2 ± 0.1 2.26 ± 0.11
Dose 1% pentobarbital (mL) 8.67 ± 1.44 7.38 ± 0.88
Operating time (min) 150 ± 20* 84 ± 20.8
Artery diameter, preoperative (mm) 1.73 ± 0.18 1.8 ± 0.21
Vein diameter, preoperative (mm) 2.73 ± 0.51 2.48 ± 0.65

Intimal thickness and immunohistochemistry score 3 weeks after surgery

Hydraulic expansion (n = 6) Control (n = 6) F4,11 P
Intimal thickness (mm) 39.20 ± 3.78 39.34 ± 1.91 0.95 0.51
Expression of TGF-β1 (score) 4.32 ± 0.31 5.32 ± 0.91 0.60 0.71
Expression of CTGF (score) 3.70 ± 0.05 4.90 ± 0.09 7.87 0.01*
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