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

초록

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 mm(2) vs. 5.1 +/- 0.43 mm(2), P < 0.05). Mean SMC counts measured at 1 and 2 weeks after cutdown were significantly tower in the treatment group (2 weeks; 115 +/- 22 vs. 62 +/- 22). Paclitaxel was undetectable in systemic circulation (<10 ng/mL). Conclusion: Sustained perivascutar delivery of paclitaxel with fibrin glue was effective in inhibiting neointimal hyperplasia in rat jugular vein after open cutdown.

키워드