OBJECTIVE

To evaluate an expression of vascular endothelial growth factor-165 (VEGF) in vascular wall at various stages of peripheral artery disease (PAD) and methods of surgical treatment.

MATERIAL AND METHODS

There were 25 patients with PAD stage III—IV. All patients admitted to the hospital for primary open surgery or repeated arterial reconstruction. After signing an informed consent, intraoperative specimen representing all three layers of vascular wall was harvested. Specimens without visible signs of atherosclerosis in patients who underwent reconstructive vascular surgery were used as arterial control. VEGF-165 expression was evaluated using Western blotting.

RESULTS

VEGF-165 expression was higher by 20.8% in arterial specimens without visible signs of atherosclerosis (control) compared to the veins removed due to lower limb varices (p=0.045). Vein arterialization (autovenous graft) was followed by increase in VEGF-165 expression and no differences with the control specimens. In patients with PAD stage III, VEGF-165 expression within the atherosclerotic plaque was similar to that in the control group. In patients with PAD stage IV, this value was increased by 42.8% (p=0.059). In stable atherosclerotic plaques, VEGF-165 expression was similar to that in the arteries without visible signs of atherosclerosis. At the same time, VEGF-165 expression was increased by 53.2% in the arteries with unstable atherosclerotic plaques (p=0.022).

CONCLUSION

VEGF-165 has a double function in vascular pathology. On the one hand, this factor stimulates angiogenesis that was shown in arterialized vein. On the other hand, VEGF-165 contributes to destabilization of atherosclerotic plaque.