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Lipid-rich lesions develop in normolipemic rabbit aortae in response to continuing injury associated with an indwelling polyethylene catheter. Lipid disappears from these lesions when the catheter is removed. In contrast following removal of the endothelium by Fogarty balloon catheter, lipid accumulation, located mainly in areas of the neointima covered by regenerated endothelium, persists and increases over time. We have previously shown that this lipid accumulation, in areas of endothelial regeneration following balloon deendothelialization, is associated with an increase in GAG visualized by ruthenium red staining as large granules (RRG) seen on transmission electron microscopy in the interstitium of the neointima. Moreover there was a marked decrease in the concentration of large granules in the areas of neointima uncovered by endothelium where lipid accumulation was minimal or absent. In the present experiment, polyethylene catheters were placed in the aortae of rabbits and removed after 3 weeks. Early thrombi, raised lipid-containing lesions, flat lipid-free lesions and samples of normal aortae were examined at this time. Four weeks and 8 weeks following catheter removal, raised lesions, flat lesions and samples of normal aorta were examined. The GAG was quantitated by counting the RRG/square micron of intercellular space. Early, unorganized thrombi showed lipid- containing macrophages in the superficial part of the lesion and very few RRG (7±3/p2). Thrombi showing early organization without lipid vacuoles in the smooth muscle cells showed the content of RRG to be (52±19/μ2) half that of raised lesions containing lipid (115±13/μ2). Lipid-free lesions at 4 and 8 weeks following catheter removal showed less RRG granules (5±3/μ2) than control tissue (24±39/μ2) . Thus the accumulation and disappearance of lipid parallels the concentration of GAG in the interstitium of the neointima.

GlycoSaminoglycan (GAG) Distribution In Catheter Induced Lesions In Rabbit Aortae In Relation To Lipid Accumulation