Effect of N-acetylcysteine on intimal hyperplasia and endothelial proliferation in rabbit carotid artery anastomosis

Abstract

Introduction: Neointimal hyperplasia due to smooth muscle cell migration and proliferation, as well as extracellular matrix accumulation, plays an important role in stenosis and restenosis that develop after reconstructive vascular interventions. Various agents are being tested to reduce neointimal hyperplasia and to prevent lumen stenosis. In the present study, the effect of N-acetylcysteine (NAC) on intimal hyperplasia and endothelial hyperplasia after carotid anastomosis was investigated in a rabbit model. Material and methods: In the course of the study, rabbits were divided into two groups. The control group (n = 7) underwent right carotid artery anastomosis and received no medication. The NAC group (n = 7) underwent right carotid artery anastomosis and received NAC for 21 days following surgery. NAC was administered at a dose of 150 mg/kg/day just after the surgery. The carotid artery underwent anastomosis, and the histological examination findings of anastomosed and opposite non-anastomosed carotid arteries were compared in two experimental groups that either received NAC or did not. Results: Compared with the control group, the reduction in the lumen area and diameter after anastomosis was significantly recovered in the NAC group (p = 0.018; p = 0.612). Increases in the intima and media areas and the intima/media ratio were smaller in the NAC group after anastomosis than in the control group, but the differences were not significant. Conclusions: We believe that vascular anastomosis and post-intervention NAC administration will prolong vascular patency by reducing intimal hyperplasia and providing vascular remodeling.