Intimal response of saphenous vein to intraluminal trauma by simulated angioscopic insertion

Abstract

Endothelial damage after simulated angioscopic insertion was evaluated in 22 dogs by radioimmunoassay of endogenous 6-keto-prostaglandin F1 alpha (stable product of prostacyclin produced by the endothelium) by means of a closed perfusion system and scanning electron microscopy. In 20 dogs, a 1.7 mm diameter polyethylene tube similar in size and physical characteristics to a commercially available angioscope was passed once into the distal venotomy site and out of the proximal venotomy site for a total distance of 15 cm in the left saphenous vein (group A) and 10 times in both directions in the right saphenous vein, destroying all valves (group B). The vein segments were examined immediately after simulated angioscopic insertion and at intervals of 2, 3, and 4 weeks. The remaining two dogs were used as control animals to establish baseline prostacyclin production. All veins were patent when harvested. Scanning electron microscopy revealed globular and contracted endothelial cells in some areas of group A veins, whereas partial longitudinal absence of endothelial cells was noted in group B veins. Intimal coverage was complete by 2 weeks in group A veins and between 3 and 4 weeks in group B veins. Prostacyclin synthesis of group B veins was significantly less than that of group A at day 1 and at 2 weeks after operation (p less than 0.05), reaching that of control vein synthesis by 4 weeks. This study suggests that simulated angioscopic trauma of the luminal surface of the canine saphenous vein had no negative effect on early patency.

Intravascular imaging methods for venous disorders

“…Complications of intravascular imaging are direct trauma by catheter manipulation, thrombosis by intimal damage, lesion to venous valve, bacterial contamination, septicemia, and water volume overload [15]. Hashizume et al [16] reported that angioscope application caused venous intimal damage in dogs. However, the damaged portion recovered in a short time and he emphasized that the angioscope is useful and safe.…”

External valvuloplasty for primary valvular incompetence of the lower limbs using angioscopy

“…Angioscopic direct vision contributes to a reliable valvuloplasty technique and observation of cusp adaptation after valvuloplasty. It was reported that intima of the vein was damaged by use of an angioscope, but this heals after a short period and has no effect on vein patency [15].…”

Simulated blood flow and the effects on prostacyclin production in the dog femoral artery.

“…We classified the electromagnetically measured blood flow waveform at reconstructive surgery into five types and found a close correlation between the ultimate result of the arterial reconstruction and intraoperative blood flow waveforms. 12 We found that grafts with the type 0 or I flow waveform pattern (normal flow group, characterized by steep acceleration and deceleration) had a long-term patency, and in grafts with the type II, III, or IV flow waveform pattern (abnormal flow group, characterized by gentle sloping), graft failure was frequent.…”