Sassi C, Tanganelli P, Sani G, Antonelli R, Paolini G, Stefano P L, Salvi M, Cosimi A, Pula G, Giomarelli P P
Ann Chir. 1989;43(8):632-5.
In order to observe ultrastructural changes of the saphenous vein before implantation during coronary artery by-pass surgery, 58 fragments from a series of 29 consecutive patients, were studied by means of scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Two fragments were taken: the first just before the distal anastomosis; the second just before the last anastomosis on the aorta. The vein graft was kept in a finger solution of 10% nitroglycerin. Forced dilatation was avoided. The EM showed areas of early loss of the endothelial layer, not time-related, deposits of fibrin and blood corpuscular elements with muscular contraction in 75% of the examined grafts. From our experience and according to the literature, loss of the endothelial layer, spasm and early platelet and fibrin aggregation, are constant features of the explanted saphenous vein. In clinical practice, we emphasize, in addition to the "no touch technique", the early use of antiplatelet drugs during coronary artery by-pass coronary surgery.
为观察冠状动脉搭桥手术中植入前大隐静脉的超微结构变化，对连续29例患者的一系列58个静脉片段进行了扫描电子显微镜（SEM）和透射电子显微镜（TEM）研究。取两个片段：第一个在远端吻合术前；第二个在主动脉最后一个吻合术前。静脉移植物保存在10%硝酸甘油的指套溶液中。避免强行扩张。电子显微镜显示，在75%的检查移植物中，存在内皮早期丢失区域，与时间无关，有纤维蛋白和血细胞成分沉积以及肌肉收缩。根据我们的经验并参考文献，内皮丢失、痉挛以及早期血小板和纤维蛋白聚集是取出的大隐静脉的常见特征。在临床实践中，我们强调，除了“非接触技术”外，在冠状动脉搭桥手术中应尽早使用抗血小板药物。
