title: Comparison of conventional and no-touch techniques in harvesting saphenous vein for coronary artery bypass grafting in view of endothelial damage.
abstract: BACKGROUND
  Optimization of saphenous vein patency for myocardial revascularization.
  
  
  OBJECTIVE
  The goal of this study was to present the no-touch technique of saphenous vein preparation. This technique consists of harvesting the vein with a pedicle of surrounding tissue, which protects the vein from distension pressure.
  
  
  METHODS
  We performed a prospective, randomized study that compared 2 techniques for harvesting saphenous vein-conventional and no-touchin 40 patients undergoing coronary artery bypass grafting. We carried out a morphologic study of the endothelium with the aid of light and transmission electron microscopy and an immunohistochemical assessment to identify adenosine, inducible nitric oxide synthase (iNOS), and vascular endothelial growth factor (VEGF) in the vein wall.
  
  
  RESULTS
  The integrity of endothelial cell and all vascular layers was maintained better with the no-touch technique than with the conventional procedure. The immunohistochemical assessment revealed that adenosine receptor, iNOS, and VEGF immunoexpression levels were normal or lower in the no-touch group than in the conventional-harvest group, as shown by the staining densities in all layers of the vein wall.
  
  
  CONCLUSIONS
  Endothelial integrity and adenosine, iNOS, and VEGF immunoreactivities were better preserved when the no-touch technique was used for vein graft harvesting. The mechanical protection provided by the cushion of surrounding tissue in the no-touch group and the vasorelaxation and thromboresistant activities of nitric oxide may be responsible for the reduction in vasospasms and the improved patency rate.
authors: Department of Cardiovascular Surgery, Istanbul Bilim University School of Medicine, Istanbul. dronursen@yahoo.com
authors: Onur
authors: O
authors: Sen
authors: Suheyla
authors: S
authors: Gonca
authors: Seyhun
authors: S
authors: Solakoglu
authors: Hakki
authors: H
authors: Dalcik
authors: Cannur
authors: C
authors: Dalcik
authors: Ahmet
authors: A
authors: Ozkara
mesh_terms: D000328:Adult; D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000276:immunology* / Q000601:surgery*; D004730:Endothelium, Vascular / Q000276:immunology* / Q000293:injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052247:Nitric Oxide Synthase Type II / Q000276:immunology; D011446:Prospective Studies; D012501:Saphenous Vein / Q000276:immunology* / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology
chemical_list: D042461:Vascular Endothelial Growth Factor A; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II