title: Collagen-elastin ratio predicts burst pressure of arterial seals created using a bipolar vessel sealing device in a porcine model.
abstract: BACKGROUND
  Bipolar electrosurgical devices are used to generate rapid and efficient hemostasis in a wide range of surgical procedures. Of the factors that influence seal integrity, vessel (artery) diameter has been considered the most important variable. In this study we hypothesized that the relative ratio of the components that form the seal (collagen and elastin) determine the degree of vessel distensibility and play an equally important role in defining seal strength.
  
  
  METHODS
  Porcine carotid, renal, iliac, and femoral arteries were sealed using a bipolar electrosurgical device in vivo. Following removal, arterial diameter was measured and vessels' seals tested for arterial burst pressure (ABPr). Samples were then analyzed histologically and biochemically for collagen and elastin content.
  
  
  RESULTS
  Arteries with the highest collagen-elastin ratio (C/E) (renal) consistently demonstrated significantly higher burst pressures than those arteries with lower C/E ratios (iliac and femoral) independent of artery diameter.
  
  
  CONCLUSIONS
  Using arteries of distinct anatomical origin and physiological function, we demonstrate that total collagen content, and more specifically C/E ratio, in porcine arteries is a more accurate predictor of ABPr than vessel size alone.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA. David.Sindram@carolinashealthcare.org
authors.forename: David
authors.initials: D
authors.lastname: Sindram
authors.forename: Kimberly
authors.initials: K
authors.lastname: Martin
authors.forename: Jarrod P
authors.initials: JP
authors.lastname: Meadows
authors.forename: Ajita S
authors.initials: AS
authors.lastname: Prabhu
authors.forename: Jessica J
authors.initials: JJ
authors.lastname: Heath
authors.forename: Iain H
authors.initials: IH
authors.lastname: McKillop
authors.forename: David A
authors.initials: DA
authors.lastname: Iannitti
mesh_terms: D000818:Animals; D001158:Arteries / Q000601:surgery*; D003094:Collagen / Q000032:analysis*; D004548:Elasticity; D004549:Elastin / Q000032:analysis*; D004598:Electrosurgery; D005260:Female; D011312:Pressure; D013552:Swine
chemical_list: D003094:Collagen; D004549:Elastin