Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model.
OBJECTIVE
The saphenous vein is the most commonly used graft in coronary artery bypass surgery, since no suitable arterial graft is available. However, the frequency of late graft failure is a cause for research into graft protection. The objective of this study was to investigate the effect of synthetic adhesive cyanoacrylate administration on the saphenous vein graft for preventing vascular damage due to internal pressure on the graft.


METHODS
In this study we enrolled 20 volunteer subjects who had undergone coronary artery bypass surgery and who had excess saphenous vein grafts. Perivascular cyanoacrylate was administered to one of two saphenous vein grafts explanted from each patient. The other saphenous vein graft from each patient was not treated and was used as the control. A model of the arterial system was created using a saphenous vein cardiopulmonary bypass system. Circulation was maintained at 120 mmHg for 45 minutes. Afterwards, the grafts were subjected to histopathological examination.


RESULTS
The cyanoacrylate group of grafts did not develop severe vascular damage compared with many instances of moderate and severe damage due to compression in the control group of grafts (p = 0.003).


CONCLUSIONS
Perivascular administration of cyanoacrylate appeared to be successful in the prevention of early saphenous vein graft injury. No in vivo study has been performed to date to assess endothelial damage in the saphenous vein, in order to demonstrate the long-term effect of cyanoacrylate. Further investigations are needed in this regard.
Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
Nail
N
Kahraman
Namik Kemal University, Tekirdag, Turkey. gunduzyumun@gmail.com.
Gunduz
G
Yumun
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
Arif
A
Gücü
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
Kadir K
KK
Özsin
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
Temmuz
T
Taner
Department of Pathology, Erzurum Education and Research Hospital, Erzurum, Turkey.
Ebru
E
Şener
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
Mehmet T
MT
Göncü
D000287:Administration, Topical; D000336:Aerosols; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D003487:Cyanoacrylates / Q000008:administration & dosage*; D019610:Cytoprotection; D006801:Humans; D008953:Models, Anatomic; D012501:Saphenous Vein / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*; D013314:Stress, Mechanical; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014690:Venous Pressure
D000336:Aerosols; D003487:Cyanoacrylates; D014014:Tissue Adhesives