{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:45:40Z","timestamp":1791819940543,"version":"4.3.4"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:p>\n                    Stenosis from venous neointimal hyperplasia is common in native arteriovenous fistulas (AVFs). However, the preexisting histologic characteristics of veins at fistula creation, and associations thereof with baseline patient factors, have not been well characterized. In this study, we conducted histologic analysis of a segment of the vein used for anastomosis creation, obtained during AVF creation from 554 of the 602 participants in the multicenter Hemodialysis Fistula Maturation Cohort Study. We quantified intimal and medial areas and lengths of the internal and external elastic lamina by morphometry and assessed venous wall cells by immunohistochemistry, extracellular matrix with Movat stain, and calcium deposition by alizarin red stain. We also studied a representative subset of veins for markers of monocyte\/macrophage content, cell proliferation, apoptosis, and neoangiogenesis. Neointima occupied &gt;20% of the lumen in 57% of fully circumferential vein samples, and neointimal hyperplasia associated positively with age and inversely with black race. The neointima was usually irregularly thickened, sometimes concentric, and contained\n                    <jats:italic toggle=\"yes\">\u03b1<\/jats:italic>\n                    \u2013smooth muscle actin\u2013expressing cells of smooth muscle or myofibroblast origin. Proteoglycans admixed with lesser amounts of collagen constituted the predominant matrix in the neointima. In 82% of vein samples, the media of vessel walls contained large aggregates of collagen. A minority of veins expressed markers of inflammation, cell proliferation, cell death, calcification, or neoangiogenesis. In conclusion, we observed preexisting abnormalities, including neointimal hyperplasia and prominent accumulation of extracellular matrix, in veins used for AVF creation from a substantial proportion of this cohort.\n                  <\/jats:p>","DOI":"10.1681\/asn.2016050598","type":"journal-article","created":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T21:10:39Z","timestamp":1500498639000},"page":"3076-3088","source":"Crossref","is-referenced-by-count":60,"title":["Histopathology of Veins Obtained at Hemodialysis Arteriovenous Fistula Creation Surgery"],"prefix":"10.1681","volume":"28","author":[{"given":"Charles E.","family":"Alpers","sequence":"first","affiliation":[{"name":"Department of Pathology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter B.","family":"Imrey","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;"},{"name":"Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly L.","family":"Hudkins","sequence":"additional","affiliation":[{"name":"Department of Pathology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz A.","family":"Wietecha","sequence":"additional","affiliation":[{"name":"Department of Pathology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Radeva","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Allon","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred K.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension and"},{"name":"Renal Section, Medical Service, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah;"},{"name":"Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Dember","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division and"},{"name":"Division of Nephrology, University of Arizona College of Medicine, Tucson, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabir","family":"Roy-Chaudhury","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Arizona College of Medicine, Tucson, Arizona;"},{"name":"Formerly, Division of Nephrology and Hypertension, University of Cincinnati College of Medicine, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Ting","family":"Shiu","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension and"},{"name":"Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christi M.","family":"Terry","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension and"},{"name":"Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alik","family":"Farber","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald J.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;"},{"name":"Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold I.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania;"},{"name":"Division of Nephrology, University of Arizona College of Medicine, Tucson, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Kusek","sequence":"additional","affiliation":[{"name":"Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Himmelfarb","sequence":"additional","affiliation":[{"name":"Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Hemodialysis Fistula Maturation Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,7,19]]},"reference":[{"key":"B1-20230819","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.2215\/CJN.11251210","article-title":"Outcomes of arteriovenous fistula creation after the fistula first initiative.","volume":"6","author":"Schinstock","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2-20230819","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1038\/sj.ki.5001747","article-title":"Why don\u2019t fistulas mature?","volume":"70","author":"Dixon","year":"2006","journal-title":"Kidney Int"},{"key":"B3-20230819","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1053\/j.ajkd.2011.04.018","article-title":"Medial fibrosis, vascular calcification, intimal hyperplasia, and arteriovenous fistula maturation.","volume":"58","author":"Allon","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"B4-20230819","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1053\/j.ajkd.2013.03.040","article-title":"Correlation of pre-existing vascular pathology with arteriovenous graft outcomes in hemodialysis patients.","volume":"62","author":"Allon","year":"2013","journal-title":"Am J Kidney Dis"},{"key":"B5-20230819","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.2215\/CJN.02740313","article-title":"Preoperative venous intimal hyperplasia, postoperative arteriovenous fistula stenosis, and clinical fistula outcomes.","volume":"8","author":"Allon","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"B6-20230819","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1093\/ndt\/gfq733","article-title":"Severe venous neointimal hyperplasia prior to dialysis access surgery.","volume":"26","author":"Lee","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B8-20230819","doi-asserted-by":"crossref","first-page":"168","DOI":"10.5301\/jva.5000024","article-title":"Inflammation, oxidation and venous neointimal hyperplasia precede vascular injury from AVF creation in CKD patients.","volume":"13","author":"Wasse","year":"2012","journal-title":"J Vasc Access"},{"key":"B9-20230819","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/hdi.12289","article-title":"Morphometric and histological parameters in veins of diabetic patients undergoing brachiocephalic fistula placement.","volume":"19","author":"Lazich","year":"2015","journal-title":"Hemodial Int"},{"key":"B10-20230819","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1053\/j.ajkd.2013.06.024","article-title":"Objectives and design of the hemodialysis fistula maturation study.","volume":"63","author":"Dember","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"B11-20230819","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1083\/jcb.201412052","article-title":"Recent insights into the cellular biology of atherosclerosis.","volume":"209","author":"Tabas","year":"2015","journal-title":"J Cell Biol"},{"key":"B12-20230819","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1161\/01.ATV.0000090130.85752.ED","article-title":"Arterial smooth muscle cell heterogeneity: implications for atherosclerosis and restenosis development.","volume":"23","author":"Hao","year":"2003","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B13-20230819","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1161\/01.RES.77.3.445","article-title":"The intima. 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