Endothelial injury and vascular dysfunction associated with the Fogarty balloon catheter

Endothelial-derived relaxing factor is an important modulator of vascular relaxation, and its production is very sensitive to endothelial injury. The abdominal aortas of five groups of rabbits were subjected to Fogarty balloon catheterization via the femoral artery. Some rabbits were killed immediately (time 0), and others were killed at weekly intervals. At time 0, isolated vascular rings sectioned from the abdominal aortas and suspended in tissue baths failed to exhibit any endothelial-derived relaxing factor dependent vascular relaxation. Vascular relaxation progressively returned but was not normal until 4 weeks after the initial injury. Morphologic changes studied by means of Evans blue dye and by scanning electron microscopy with silver staining corresponded well with these functional changes. At time 0, the delicate endothelium was completely denuded, but it progressively regenerated over the subsequent 4 weeks. This severe injury to the vascular endothelium and the resultant vascular dysfunction may result in an increased risk of early postoperative spasm and thrombosis after the use of a Fogarty balloon catheter. (J Vasc Surg 1989;9:422–5.)