The native venous architecture is preserved in an arterialized deep dorsal vein graft for arteriogenic impotence: a case report.
Endothelial injury in a deep dorsal vein graft may result from thermal, ischemic or mechanical trauma during surgical preparation or following exposure to systemic blood pressures and flow. We removed a functioning in situ deep dorsal vein graft section 10 months after microvascular arterial bypass surgery due to glans hyperemia. This section was compared and contrasted histomorphologically with a preoperative deep dorsal vein section that was procured for routine histological examination before the arteriovenous anastomosis. Detailed examination of the vein graft tissues by light microscopy, computer morphometrics and immunological staining demonstrated no evidence of vascular pathology. In the normal, healthy deep dorsal vein graft exposure to systemic arterial blood pressures and flow for 10 months did not result in myointimal proliferative lesions. Such histological changes seem more likely to be attributable to endothelial injury following iatrogenic surgical trauma. In situ vein grafts offer the opportunity to use "no-touch" endothelium preserving vascular techniques. Use of these grafts may improve long-term clinical results in penile microvascular arterial bypass surgery for impotence as it has in other vascular beds.
Hatzichristou
D G
DG
Department of Urology, Boston University School of Medicine, Massachusetts.
Goldstein
I
I
Kasznica
J
J
Quist
W
W
D000328:Adult; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D004730:Endothelium, Vascular / Q000293:injuries*; D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006940:Hyperemia / Q000209:etiology; D007049:Iatrogenic Disease; D007124:Immunoenzyme Techniques; D008297:Male; D010410:Penile Erection / Q000502:physiology; D010413:Penis / Q000098:blood supply*; D014680:Veins / Q000473:pathology