Micromorphology of Skeletonized and Pedicled Internal Thoracic and Radial Arteries

Мамчур, С. Е.; Бохан, Н. С.; Vecherskii, Yuri; Malishenko, E. S.

doi:10.1053/j.semtcvs.2015.06.010

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Studies show significant negative effects of separating an artery from its surrounding tissue. Mechanical injury during harvesting predisposes the artery to spasms, which can cause graft occlusion, intimal hyperplasia, and early graft failure . One study found degenerative changes in skeletonized ITAs and radial arteries compared to pedicled ITAs and RAs, including: splitting of internal elastic laminae, reduced tortuosity of the internal elastic laminae, and thickening and detachment of the intima .…”

Section: Introductionmentioning

confidence: 99%

“…Mechanical injury during harvesting predisposes the artery to spasms, which can cause graft occlusion, intimal hyperplasia, and early graft failure . One study found degenerative changes in skeletonized ITAs and radial arteries compared to pedicled ITAs and RAs, including: splitting of internal elastic laminae, reduced tortuosity of the internal elastic laminae, and thickening and detachment of the intima . Others have shown that experimental interruption of the aortic vasa vasorum led to abnormal morphology of elastin and collagen fibers of the outer media, which resulted in arterial wall stiffening within 15 days .…”

Section: Introductionmentioning

confidence: 99%

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Reduced arterial elasticity due to surgical skeletonization is ameliorated by abluminal PEG hydrogel

Robinson

Scott

Hesek

et al. 2017

Bioengineering & Transla Med

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Arteries for bypass grafting are harvested either with neighboring tissue attached or as skeletonized vessels that are free of surrounding tissue. There are significant benefits to skeletonization, but reports suggest that skeletonized vessels may develop structural defects and are at risk for atherosclerosis. We investigated the specific short‐term effects of skeletonization on carotid artery biomechanics and microanatomy in a rabbit model. Six carotid arteries were surgically skeletonized. To support healing, three of these received polyethylene glycol hydrogel injected along their exterior surfaces. M‐mode ultrasonography was used to track circumferential cyclic strain in the skeletonized, hydrogel‐treated, and contralateral vessels. On day 21, the arteries were harvested, and vessel structure was assessed by histology, immunofluorescence microscopy, two‐photon elastin autofluorescence, and second harmonic generation (SHG) microscopy. Intimal‐medial thickness appeared unaffected by skeletonization, but the SHG signals indicated significant changes in collagen turnover in the adventitia. Skeletonized arteries also exhibited significantly decreased radial compliance (circumferential cyclic strain dropped ∼30%) and decreased numbers of elastic laminae (9.1 ± 2.0 to 2.3 ± 1.4). Hydrogel treatment protected against these effects with treated vessels maintaining normal mechanical properties. These results indicate that arterial skeletonization triggers immediate effects on vessel remodeling and reduced vessel compliance resulting in specific tissue alterations within 21 days, but that these effects can be attenuated by the placement of hydrogel on the exterior surface of the skeletonized vessel.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduced arterial elasticity due to surgical skeletonization is ameliorated by abluminal PEG hydrogel

Robinson

Scott

Hesek

et al. 2017

Bioengineering & Transla Med

View full text Add to dashboard Cite

show abstract

“…There are several important caveats to the study by Mamchur et al 1 First, they combined manifestations of mechanical harvest injury with chronic degenerative findings that were unrelated to the harvesting approach. In addition, redundant distal or proximal portions of the arteries were trimmed off and subjected to histologic examination.…”

mentioning

confidence: 99%