Changes in venous endothelial fibrinolytic activity and histology with in vitro venous distention and arterial implantation.
We performed intraoperative pressure monitoring in a clinical setting and demonstrated that the average venous distention pressure observed during preparation of autogenous vein grafts for arterial implantation was 300 to 500 mm Hg and often exceeded 500 mm Hg. Similar data on venous distention pressures were obtained by Ramos et al [4] and by Abbott et al [1]. Although the exact relation between venous distention pressure, venous endothelial fibrinolytic activity and long-term autogenous vein graft patency is unknown, our data suggest that autogenous vein graft distention pressure should be kept under 500 mm Hg during graft procurement and static pressure testing before venous autograft implantation. Ideally, either venous distention pressure should be monitored during vein graft harvesting and preparation, and kept as low as possible, or procured autogenous vein grafts should not be statically distended but rather allowed to gradually enlarge due to pulsatile arterial flow after implantation.
D000818:Animals; D002339:Carotid Arteries / Q000601:surgery*; D004285:Dogs; D004727:Endothelium / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005342:Fibrinolysis; D066298:In Vitro Techniques; D007601:Jugular Veins / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*; D008855:Microscopy, Electron, Scanning; D011312:Pressure; D014182:Transplantation, Autologous