The research of inhibiting effect of cilostazol on intimal hyperplasia and smooth muscle cell proliferation at the anastomosis site performed in rabbit carotid artery

Objective: Intimal hyperplasia and smooth muscle cell proliferation play an important role on the restenosis after the vascular interventions. Reconstruction is one of the most common intervention in the management of the obstructing artery diseases. Recently, the success of these kind of interventions are under expectations because of spontaneous thrombosis or restenosis. After vascular reconstructive interventions unlikely the acute obstruction in which acute thrombosis is important at the late stage intimal hyperplasia caused by smooth muscle cell migration, proliferation and extracellular matrix deposition play an important role in narrowing or restenosis. Hyperplasic intimal thickening is not only an adaptive progress against the hemodynamic stress but also a characteristic of arterial injury healing. We assess the effect of cilostazol on intimal hyperplasia and smooth muscle cell proliferation at anastomosis performed in rabbit carotid artery.Materials and Method: In this study we planned to use 16 randomized New Zealand male rabbit weights 2 to 3 kilograms. Rabbits were seperated to 2 groups. A vertical neck insition was made in an appropriate position to all group rabbits and carotid artery was dissecated. The same artery transected and using 8/0 polypropylene an anastomosis was performed with by one by technique. Group A rabbits (8) assigned as control group. No medication was given to this group. Cilostazol was administrated to group B(8) 30-50 mgr/kg/day twice a day peroral during 21 days. At the end of the day 21 the anostomosis performed carotid artery segments and the contralateral carotid artery of all rabbits were sent to histology laboratory to analyze. The preperations were examined under light microscope. Images were analyzed via digital image analyze program and lumen diamater, lumen area, intimal area, medial area and intima-media area ratio were estimated and results were evaluated. Serial cross-sections taken from paraffin tissues were photographed and transferred to computer environment. Intimal and medial areas were measured and the sections were three dimensioned via Reconstruct 1.0.9.9 (JC Fiala) program.Findings: In the serial sections the average lumen diamater of group B was found higher than the group A and this difference was statically significant between group B and group A. The lumen area of group B was found higher than the group A and this difference was significant between group B and group A. When the section series were evaluated for area of intima of group B was lesser than group A and the difference was statically significant between group B and group A. The evaluation of medial area of group B was higher than group A and the difference was statically significant between group B and group A. The evaluation of intima /media area ratio showed that it was higher in group A compared with group B and the difference was significant. No statistical significance was observed between control groups with regards to luminal diameter, luminal area, intimal area, medial area and ratio of the areas of intima to media.Conclusion: Cilostazol may be a beneficial agent for preventing intimal hyperplasia and smooth muscle cell proliferation after the vascular surgery.