Effects Of Different Solutions On Postoperative Restenosis Of Rabbit External Jugular Vein Graft

Purpose: To study effects of different solutions on the integrity of the endotheliumof rabbits external jugular vein and on vein graft restenosis by transplanting theautogenous external jugular veins to common carotid arteries.Methods: Forty rabbits were randomized into four groups(ten in each) according todifferent treatments: heparinized saline group, papaverine group, GlycerylTrinitrate-Verapamil(GV) solution group and GALA solution group. Application ofdifferent solutions to distend jugular vein with 50mmHg pressure two times duringharvesting were performed and then veins were stored in different solutions60mins.Then the veins were cut into 2 segments. One was for endothelial integritygrading by SEM examination. The other was interposed between contralateralcommon carotid arteries. The vein grafts were harvested at 2 weeks after grafting.Neintimal square-to-luminal square ratio (S1/S2) was measured with a computerizedimage analysis system.Results: Three rabbits were died during the experiment period but the veins werepatent, and the others were alive. Veins in heparinized saline group and papaverinegroup were severe EC denudation. The endothelium grade of heparinzed saline groupwas significantly higher than in GV group(3.5000 vs 2.0000,P<0.001)and GALAgroup(3.5000 vs 1.9000,P<0.001).And the endothelium grade of papverine groupwas significantly higher than in GV group(3.6250 vs 2.0000,P<0.001) and GALAgroup(3.6250 vs 1.9000,P<0.001),too. Fourteen days after implantation , all veinswere patent . The S1/S2 ratio of heparinized saline group veins(52.81172%) andpapaverine group veins(50.39125%) were significantly higher than that of the GVsolution group veins(45.71280%)and GALA solution group veins(44.08253%),butthe S1/S2 ratio of four different group veins adjacent to anastomoses was nearly ofdifference.Conclusions: (1) GV solution and GALA solution caused milder restenosis thanheparinized saline and papaverine. The explanation of the difference may be that theypreserved the structural integrity of veins better than the other two. (2) Restenosis ofstoma may be less relation with solutions and anastomoses technique and arterialhemodynamic conditions may be main points.