Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA.
Surg Endosc. 2011 Aug;25(8):2604-12. doi: 10.1007/s00464-011-1606-4. Epub 2011 Mar 15.
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.
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.
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.
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.
双极电外科设备用于在广泛的手术过程中快速有效地止血。在影响密封完整性的因素中，血管（动脉）直径被认为是最重要的变量。在这项研究中，我们假设形成密封的组件（胶原和弹性蛋白）的相对比例决定了血管的可扩张性，并在定义密封强度方面起着同样重要的作用。
使用双极电外科设备在体内密封猪颈动脉、肾动脉、髂动脉和股动脉。取出后，测量动脉直径，并测试血管爆裂压（ABPr）。然后对样本进行组织学和生物化学分析，以确定胶原和弹性蛋白含量。
胶原-弹性蛋白比值（C/E）最高的动脉（肾动脉）的爆裂压始终明显高于 C/E 比值较低的动脉（髂动脉和股动脉），而与动脉直径无关。
使用具有不同解剖学起源和生理功能的动脉，我们证明猪动脉中的总胶原含量，特别是 C/E 比值，比血管大小更能准确预测 ABPr。
