The natural history of intimal flaps in a canine model
A. P. Sawchuk, J. Eldrup-Jorgensen, C. Tober, D. McCoy, J. Durham, B. Waller, J. J. Schuler and D. P. Flanigan
Department of Surgery, University of Illinois College of Medicine, Chicago.
The natural history of arterial intimal flaps has not been well defined.
This study characterizes the natural history of unrepaired intimal flaps.
Thirty-nine 1-, 2-, and 3-mm hemispheric, distally based intimal flaps were
made in 4- to 5-mm diameter canine femoral and carotid arteries. Twenty
arteries had 2- and 3-mm intimal flaps and were monitored for short-term
arterial thrombosis and flap extension. Nineteen had 1- and 2-mm intimal
flaps and were monitored for thrombosis, long-term development of
neointimal hyperplasia, arterial stenosis, and persistence of the flap.
While 40% of the arteries with 3-mm intimal flaps developed thrombosis in 3
to 5 days, only 3% of the arteries with 1- or 2-mm intimal flaps developed
thrombosis. Most 1- to 2-mm intimal flaps resolved and the subsequent
development of neointimal hyperplasia or arterial stenosis was minimal.
Arteries with hemodynamically significant stenoses from intimal flaps
warrant repair, while arteries with smaller intimal flaps may not require
repair.
