Objective:
Endoscopic vein harvest for lower extremity arterial bypass technique has been questioned due to concern for endothelial damage during procurement. We sought to compare NO mediated endothelial dependent relaxation (EDR) in vein segments harvested with open surgical (OH) versus endoscopic (EH) techniques.
Methods:
Saphenous vein segments were harvested for lower extremity bypass. 3-4mm vein rings were mounted on force transducers. Segments were mounted in 37° oxygenated Krebs solution and maximally contracted using KCl. NE was used to achieve submaximal contraction. EDR was determined using increasing concentrations of bradykinin (BDK). Endothelial independent relaxation was confirmed using sodium nitroprusside. Two-way ANOVA was used to analyze differences between harvest techniques across BDK concentration. Student t-test was used to examine nitrite levels in each cohort.
Results:
Vein segments harvested from patients (n=13) led to 28 rings (11 rings; 5 patients EH v. 17;8 OH). Both cohorts achieved moderate relaxation to maximal BDK concentration, [10
-6
M]; (49.5% EH vs. 40.55%, OH, P = .270). Analysis by two way ANOVA for mean % relaxation for BDK concentration [10
-11
- 10
-6
M] showed improved EDR in EH samples compared to OH (P =.029). Mean nitrite tissue bath concentration measurements post-BDK were 279 nM (EH) v. 194 nM (OH) (P = .264). Histology and IHC confirmed intact endothelium by morphometric analysis and CD31 staining.
Conclusion:
Endothelial function is preserved when utilizing endoscopic harvesting techniques. The advantages of minimally invasive vein procurement for lower extremity bypass can be obtained without concern for damaging venous endothelium.
Hatching and harvesting techniques for Artemia cysts with different effects of salinity in the district of Situbondo, East Java
