Abstract: Objective To establish a model of cimino-brescia arteriovenous fistula by anastomosing rabbit carotid artery with internal jugular vein and to explore the mechanism of coated sirolmus in inhibiting the fistula anastomotic intimal hyperplasia. Methods A total of 18 healthy New Zealand male rabbits were randomly divided into blank control group(the grafts accepted no management), F-127 group(0.5 mL of 20% pluronic F-127 gel was locally applied on adventitia and anastomosis site)and F-127+sirolmus group(0.5 mL 20% pluronic F-127 gel containing 0.5 mg sirolmus was locally applied on adventitia and anastomosis site)to establish models of cimino-brescia arteriovenous fistula by anastomosing rabbit carotid artery with internal jugular vein. Three weeks after operation, the anastomotic veins were 山 东 大 学 学 报 (医 学 版)54卷8期 -牛纪媛,等.局部外膜缓释西罗莫司对内瘘血管内膜增生的影响 \=-harvested. The vein intimal hyperplasis was observed with tissue morphology method, the vascular intima thickness was measured with computer image system, and expressions of TGF-β1 and CTGF were detected with immunohistochemistry and western blotting. Results Three weeks after operation, the intima in the blank control group and F-127 group thickened obviously as compared with that in F-127+sirolmus group(P<0.05). The TGF-β1 and CTGF expression were higher in the blank control group and F-127 group than in the F-127+sirolmus group(P<0.05). There were no significant differences in the above parameters between the blank control group and F-127 group(P>0.05). Conclusion Sirolmus partial paintcoated in vascular adventitia inhibits the fistula neointimal hyperplasia via inhibition of TGF-β1 and CTGF expressions.

Key words: Cimino-brescia arteriovenous fistula, Intimal hyperplasia, Sirolmus, Transforming growth factor-β1, Connective tissue growth factor