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Neointimal formation at the sites of anastomosis of the internal thoracic artery grafts after coronary artery bypass grafting in human subjects: An immunohistochemical analysis Mitsuharu Hosono, MDa, Makiko Ueda, MDb, Shigefumi Suehiro, MDa, Yasuyuki Sasaki, MDa, Toshihiko Shibata, MDa, Koji Hattori, MDa, Hiroaki Kinoshita, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 120, Issue 2, Pages (August 2000) DOI: /mtc Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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Fig. 1 Micrographs of a body segment 2 days after grafting. Panels A-E represent serial sections. A, Elastic tissue stain. No injuries are seen in the arterial wall. B, Staining with anti-vWf. The luminal surface is completely covered by vWf-positive endothelial cells. C, Staining with HHF-35. SMCs in the media are positive with HHF-35. D, Staining with CGA-7. SMCs in the media are also positive with CGA-7, indicating that these SMCs are highly differentiated. E, Staining with HAM-56. Scattered macrophages are found in the adventitia, but no macrophages are present in the media. (Original magnification 64×.) The Journal of Thoracic and Cardiovascular Surgery , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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Fig. 2 Micrographs of an anastomotic site 2 days after grafting. Panels A and B are serial sections. A, Hematoxylin-eosin stain. Adherence of fibrin-platelet thrombus (T) is seen at the site of endothelial denudation and focal disruption of the internal elastic lamina of an ITA. CA, Coronary artery. B, Staining with HAM-56. Distinct infiltration of macrophages is present at the site of anastomotic injury. T, Fibrin-platelet thrombus. (Original magnification 86×.) The Journal of Thoracic and Cardiovascular Surgery , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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Fig. 3 Micrographs showing neointimal tissue formation at the anastomotic sites at different time intervals after grafting. Elastic tissue stain. A, At 19 days, early neointimal tissue (N) is seen. B, At 56 days, a more prominent neointima (N) is found. (Original magnification 129×.) The Journal of Thoracic and Cardiovascular Surgery , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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Fig. 4 Micrographs showing the cellular composition of neointimal tissue at different time intervals after grafting. Immunodouble staining for macrophages (red) and SMCs (turquoise). A, At 19 days, neointimal tissue is composed of macrophages (red) and SMCs (turquoise). B, At 23 days, abundant macrophages (red) are present in the neointima. C, At 56 days, neointimal tissue is composed mainly of SMCs (turquoise) with only occasional macrophages (red). D, At 92 days, neointimal tissue consists almost entirely of SMCs (turquoise). (Original magnification 404×.) The Journal of Thoracic and Cardiovascular Surgery , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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Fig. 5 Micrographs showing cell proliferative activity of neointimal tissue at different time intervals after grafting. Immunodouble staining for PCNA (red) and SMC actin (blue). A, At 19 days, both actin-negative dedifferentiated SMCs (arrows) and macrophages in the neointima show PCNA positivity (compared with Fig 4, A ). B, At 23 days, PCNA positivity is found in dedifferentiated SMCs (arrows) and macrophages in the neointima (compared with Fig 4, B ). C, At 56 days, there are no PCNA-positive cells in the neointima. D, At 92 days, no PCNA-positive cells are seen in the neointima. (Original magnification 539×.) The Journal of Thoracic and Cardiovascular Surgery , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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Fig. 6 Micrographs showing redifferentiation of SMCs within the neointima 56 days after grafting. A, Staining with HHF-35. Almost all spindle-shaped cells within the neointima (N) are positive with HHF-35. B, Staining with CGA-7. These cells in the neointima (N) also stain positive with CGA-7, indicating that these cells are highly differentiated SMCs. (Original magnification 322×.) The Journal of Thoracic and Cardiovascular Surgery , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions
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