Effect of oral L-Arginine supplementation on intima hyperplasia after Fogarty balloon embolectomy catheterization in New Zealand Rabbit (Oryctolagus cuniculus)

Syahroni Ibnu; Bambang Sektiari Lukiswanto; Djoko Legowo; Budiono Kasirin; Ito Puruhito

doi:10.15562/bmj.v9i3.2086

Effect of oral L-Arginine supplementation on intima hyperplasia after Fogarty balloon embolectomy catheterization in New Zealand Rabbit (Oryctolagus cuniculus)

Syahroni Ibnu ,

Bambang Sektiari Lukiswanto ,

Djoko Legowo ,

Budiono Kasirin ,

Ito Puruhito ,

PDF |
DOI: https://doi.org/10.15562/bmj.v9i3.2086 |
Published: 2020-12-01

Abstract

Background: Acute limb ischemic is a disease that threatens the viability of the leg with the threat of amputation to death. Fast and accurate diagnosis is essential in the management of this disease, one of the most commonly performed surgical therapies in Indonesia is thromboembolectomy using a Fogarty catheter. Thromboembolectomy with this method is very effective but gives a variety of complications, one the complication is the occurrence of intima hyperplasia which affects the lumen restenosis of the blood vessels. The aim of this study is to determine whether the administration of oral L-Arginine as a supplement for 4 weeks after endothelial trauma with a Fogarty embolectomy balloon catheter can prevent the incidence of intimal hyperplasia of the iliac artery of the New Zealand Rabbit (Cuniculus oryctolagus).

Methods: Experimental study with 16 experimental animals of Oryctolagus cuniculus rabbits subjected to endothelial trauma with Fogarty catheters and divided into 2 groups. The control group was not given L-Arginine and the experimental group was given post-treatment oral L-Arginine for 4 weeks, then the intima-media ratio was compared with histopathological examination.

Results: There was a significant difference in the ratio of intima-media thickness between the control group (without L-Arginine administration) 5.13 Â± 4.12 and the experimental group (with L-Arginine administration) 1.18 Â± 0.59 (p=0.03 ). Significant differences were also found in the intima thickness of the control group 302.22 Â± 217.42 and the experimental group 118.21 Â± 32.59 (p=0.048). Meanwhile, for the thickness of the tunica media and the intima-media complex, there were no significant differences observed.

Conclusion: Administration of L-Arginine orally after endothelial trauma with Fogarty catheter in rabbit iliac artery significantly reduces the degree of intima hyperplasia.

References

Dobrin PB. Mechanisms and prevention of arterial injuries caused by balloon embolectomy. Surgery. 1989;106(3):457-66.
Norgen L, Hiatt WR, Dormandy JA dkk. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 2007;45 Suppl: S5-S67.
Rutherford RB. Rutherfordâ€™s vascular surgery. 7th ed. Philadelphia: Elsevier Inc; 2010. 2435 p.
Schweitzer KL, Aguam AS, Wilder JR. Complications encountered during arterial embolectomy with the Fogarty balloon catheter. Vasc Surg 1976;10:144-56.
Schwarcz TH, Dobrin PB, Mrkvicka R et al. Early myointimal hyperplasia after balloon catheter embolectomy: Effect of shear forces and multiple withdrawals. J Vasc Surg. 1988;7:495-9.
Smith J C, Smith D C, Taylor F C, Ballard J L. Fogarty Balloon Catheter Injury Revisited: A Cause for Progressive Claudication. Vasc Endovascular Surg. 2000;34:251-256.
Preiser JC, Berre PJ, Van Gossum A, et al. Metabolic effects of arginine addition to the enteral feeding of critically ill patients. Jpen J Parenter Enteral Nutr. 2001;25:182-187.
Weidinger FF, McLenachan JM, Cybulsky MI, et al. Persistent dysfunction of regenerated endothelium after balloon angioplasty of rabbit iliac artery. Circulation. 1990;81:1667-1679.
Okazaki J, Komori K, Kawasaki K, Daichiko Eguchi, Ishida M, Sugimachi K. L-Arginin inhibits smooth muscle cell proliferation of vein graft intimal thickness in hypercholesterolemic rabbits. Cardiovascular Research. 1997;36:429â€“436.
Ahasan ASML, Islam MS, Kabria ASMG, Rahman ML, Hassan MM, Udin M. Major Variation in Branches of the Abdominal aorta in New Zealand White Rabbit (Oryctolagus cuniculus). International Journal of Natural Sciences. 2012;2(4):91- 98.
Davies MG, Hagen PO. Pathobiology of intimal hyperplasia. The British journal of surgery. 1994;81(9):1254-69.
Chiu CJ. Why do radial artery grafts for aortocoronary bypass fail? A reappraisal. The Annals of Thoracic Surgery. 1976;22(6):520-3.
Clowes AW, Reidy MA, Clowes MM. Mechanism of stenosis after arterial injury. Lab Invest. 1983;49:208-215.
Tarry WC, Makhoul RG. L-arginine improves endothelium-dependent vasorelaxation and reduces intimal hyperplasia after ballon angioplasty. Arterioscler Thromb Vasc Biol. 1994;14:938-943.