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. 2017 Feb;92(2):97-104.
doi: 10.4174/astr.2017.92.2.97. Epub 2017 Jan 31.

Inhibitory effect of sustained perivascular delivery of paclitaxel on neointimal hyperplasia in the jugular vein after open cutdown central venous catheter placement in rats

Seongyup Kim  1 , Younglim Kim  2 , Ji Woong Hwang  3 , Suk-Bae Moon  2
Affiliations

Inhibitory effect of sustained perivascular delivery of paclitaxel on neointimal hyperplasia in the jugular vein after open cutdown central venous catheter placement in rats

Seongyup Kim et al. Ann Surg Treat Res. 2017 Feb.

Abstract

Purpose: Inhibitory effect of paclitaxel on neointimal hyperplasia after open cutdown has not been elucidated.

Methods: For the control group (n = 16), silicone 2.7-Fr catheters were placed via the right external jugular vein with the cutdown method. For the treatment group (n = 16), a mixture of 0.65 mg of paclitaxel and 1 mL of fibrin glue was infiltrated around the exposed vein after cutdown. After scheduled intervals (1, 2, 4, and 8 weeks), the vein segment was harvested and morphometric analysis was performed on cross-sections.

Results: Proliferation of smooth muscle cell (SMC) was strongly suppressed in the treatment group, and the ratio of neointima to vein wall was significantly reduced in the treatment group (8 weeks; 0.63 ± 0.08 vs. 0.2 ± 0.08, P < 0.05). Luminal patency was significantly more preserved in the treatment group, and the luminal area was significantly wider in the paclitaxel-treated group compared to the control group (8 weeks; 1.91 ± 0.43 mm2 vs. 5.1 ± 0.43 mm2, P < 0.05). Mean SMC counts measured at 1 and 2 weeks after cutdown were significantly lower in the treatment group (2 weeks; 115 ± 22 vs. 62 ± 22). Paclitaxel was undetectable in systemic circulation (<10 ng/mL).

Conclusion: Sustained perivascular delivery of paclitaxel with fibrin glue was effective in inhibiting neointimal hyperplasia in rat jugular vein after open cutdown.

Keywords: Central venous catheters; Fibrin; Jugular veins; Neointima; Paclitaxel.

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Conflict of interest statement

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Delineation of neointimal hyperplasia (arrow) at 1 and 2 weeks postoperatively (PO) following cutdown central venous catheter placement against whole vein wall (arrowhead). Neointimal hyperplasia was consistently thicker in the control group than in the treatment group (H&E, ×40). (A) Control group, 1 week PO, (B) paclitaxel treatment group, 1 week PO, (C) control group, 2 weeks PO, and (D) paclitaxel treatment group, 2 weeks PO.
Fig. 2
Fig. 2. Neointimal hyperplasia index was significantly lower in the treatment group.
Fig. 3
Fig. 3. (A, B) Measurement of luminal area at 8 weeks postoperatively (H&E ×40). Measured patent luminal area was larger in the treatment group than in the control group.
Fig. 4
Fig. 4. Patent luminal area was significantly wider in the treatment group than in the control group at each measured interval in the observation period.
Fig. 5
Fig. 5. Smooth muscle cell (SMC) counts in the early postoperative phases (1 and 2 weeks) measured on high-powered fields (×600) with immunohistochemical staining. SMC counts were reduced in the treatment group compared to those in the control group. (A) Control group, 1 week PO, (B) paclitaxel treatment group, 1 week PO, (C) control group, 2 weeks PO, and (D) paclitaxel treatment group, of 2 weeks PO.
Fig. 6
Fig. 6. Mean smooth muscle cell (SMC) counts were significantly lower in the treatment group than in the control group at 1 and 2 weeks postoperatively.
See this image and copyright information in PMC

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