Silva Virgílio Figueiredo, Ishigai Márcia Marcelino de Souza, Freymüller Edna, Branco João Nelson Rodrigues, Gaia Diego Felipe, Gabriel Edmo Atique, Romão Renata Aparecida Leonel, Buffolo Enio
Universidade Federal de São Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil.
Rev Bras Cir Cardiovasc. 2008 Jul-Sep;23(3):323-9. doi: 10.1590/s0102-76382008000300007.
Saphenous vein grafts (SV) used in coronary artery bypass grafting have a limited life and vein occlusion may be the final adverse effect. Efforts to develop new techniques to harvest the saphenous vein may improve the viability of the graft.
Twenty patients were randomly divided into two groups with the objective of evaluating the vascular endothelium. The No Touch (NT) technique consists in removing the saphenous vein with perivascular tissue. The conventional technique consists in harvesting with "in situ" removal of the perivascular tissue. The standard saphenous vein harvesting procedure used bridged incisions. Characteristics of the vein were considered. Evaluation of the endothelium was achieved by electron microscopy and histologic analysis using hematoxylin eosin staining. The Picrosirius and Masson Trichrome methods were used to analyze subendothelial collagen.
Electron microscopy demonstrated that the NT Group had larger non-denudated endothelial areas as well as a smaller number of degraded cells. Histological analysis showed the form and integrity of the saphenous vein layers. A larger amount of collagen fibers were identified in the NT Group.
The NT technique better preserves the saphenous vein endothelium suggesting a more viable graft in the long term.
冠状动脉旁路移植术中使用的大隐静脉移植物寿命有限，静脉闭塞可能是最终的不良后果。开发新技术采集大隐静脉可能会提高移植物的存活率。
为评估血管内皮，将20例患者随机分为两组。非接触（NT）技术是指连同血管周围组织一起切除大隐静脉。传统技术是指在“原位”切除血管周围组织的情况下采集大隐静脉。标准的大隐静脉采集程序采用桥接切口。考虑了静脉的特征。通过电子显微镜和苏木精伊红染色的组织学分析对内皮进行评估。使用天狼星红染色法和马松三色染色法分析内皮下胶原。
电子显微镜显示，NT组未剥脱的内皮面积更大，降解细胞数量更少。组织学分析显示了大隐静脉各层的形态和完整性。NT组中鉴定出更多的胶原纤维。
NT技术能更好地保留大隐静脉内皮，提示从长期来看移植物更具活力。
