Pressure-diameter relationship in the human greater saphenous vein

Wim Stooker, Murat Gök, Pieter Sipkema, Hans W M Niessen, Alexi Baidoshvili, Nico Westerhof, Evert K Jansen, Charles R H Wildevuur, Léon Eijsman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Compliance of artificial and autologous vascular grafts is related to future patency. We investigated whether differences in compliance exist between saphenous vein grafts derived from the upper or lower leg, which might indicate upper or lower leg saphenous vein preference in coronary artery bypass surgery. Furthermore, the effect of perivenous application of fibrin glue on mechanical vein wall properties was studied to evaluate its possible use as perivenous graft support.

METHODS: Vein segments (N = 10) from upper or lower leg saphenous vein grafts were collected for histopathologic examination and smooth muscle cell/extracellular matrix (SMC/ECM) ratio was calculated. This ratio is suggested to be related with vascular elastic compliance. In a second group vein graft segments (N = 6) from upper and lower leg were placed in an in vitro model generating stepwise increasing static pressure up to 150 cm H(2)O. Outer diameter was measured continuously with a video micrometer system. Distensibility was calculated from the pressure-diameter curves. A third group of vein graft segments (N = 7) was pressurized after fibrin glue application to prevent overdistension, and studied in the same setup.

RESULTS: Vein segments from the lower leg demonstrated a consistent higher relative response compared with the upper leg saphenous vein graft (0.9176 +/- 0.03993 vs 0.5245 +/- 0.02512). Both reach a plateau in the high-pressure range (> 100 cm H(2)O). A significant difference in in vitro distensibility between upper and lower leg saphenous vein was only found at a pressure of 50 cm H(2)O (p < 0.05). With fibrin glue, support overdistension is prevented as revealed by the maximum relative response between fibrin glue supported upper and lower leg saphenous vein segments (0.4080 +/- 0.02464 vs 0.582 +/- 0.051), and no plateau is reached in the pressure range up to 150 cm H(2)O.

CONCLUSIONS: No upper or lower leg saphenous vein preference could be deduced from the differences in pressure-diameter response due to loss of distensibility (and thus of compliance) in the high-pressure range. Fibrin glue effectively prevents overdistension and preserves some distensibility in the high-pressure range in both the upper and lower leg saphenous vein. This might provide a basis for clinical application of perivenous support.

Original languageEnglish
Pages (from-to)1533-8
Number of pages6
JournalThe Annals of Thoracic Surgery
Volume76
Issue number5
Publication statusPublished - Nov 2003

Cite this

Stooker, W., Gök, M., Sipkema, P., Niessen, H. W. M., Baidoshvili, A., Westerhof, N., ... Eijsman, L. (2003). Pressure-diameter relationship in the human greater saphenous vein. The Annals of Thoracic Surgery, 76(5), 1533-8.
Stooker, Wim ; Gök, Murat ; Sipkema, Pieter ; Niessen, Hans W M ; Baidoshvili, Alexi ; Westerhof, Nico ; Jansen, Evert K ; Wildevuur, Charles R H ; Eijsman, Léon. / Pressure-diameter relationship in the human greater saphenous vein. In: The Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 5. pp. 1533-8.
@article{d83d6d9b5be54e78992edba17cb03aaa,
title = "Pressure-diameter relationship in the human greater saphenous vein",
abstract = "BACKGROUND: Compliance of artificial and autologous vascular grafts is related to future patency. We investigated whether differences in compliance exist between saphenous vein grafts derived from the upper or lower leg, which might indicate upper or lower leg saphenous vein preference in coronary artery bypass surgery. Furthermore, the effect of perivenous application of fibrin glue on mechanical vein wall properties was studied to evaluate its possible use as perivenous graft support.METHODS: Vein segments (N = 10) from upper or lower leg saphenous vein grafts were collected for histopathologic examination and smooth muscle cell/extracellular matrix (SMC/ECM) ratio was calculated. This ratio is suggested to be related with vascular elastic compliance. In a second group vein graft segments (N = 6) from upper and lower leg were placed in an in vitro model generating stepwise increasing static pressure up to 150 cm H(2)O. Outer diameter was measured continuously with a video micrometer system. Distensibility was calculated from the pressure-diameter curves. A third group of vein graft segments (N = 7) was pressurized after fibrin glue application to prevent overdistension, and studied in the same setup.RESULTS: Vein segments from the lower leg demonstrated a consistent higher relative response compared with the upper leg saphenous vein graft (0.9176 +/- 0.03993 vs 0.5245 +/- 0.02512). Both reach a plateau in the high-pressure range (> 100 cm H(2)O). A significant difference in in vitro distensibility between upper and lower leg saphenous vein was only found at a pressure of 50 cm H(2)O (p < 0.05). With fibrin glue, support overdistension is prevented as revealed by the maximum relative response between fibrin glue supported upper and lower leg saphenous vein segments (0.4080 +/- 0.02464 vs 0.582 +/- 0.051), and no plateau is reached in the pressure range up to 150 cm H(2)O.CONCLUSIONS: No upper or lower leg saphenous vein preference could be deduced from the differences in pressure-diameter response due to loss of distensibility (and thus of compliance) in the high-pressure range. Fibrin glue effectively prevents overdistension and preserves some distensibility in the high-pressure range in both the upper and lower leg saphenous vein. This might provide a basis for clinical application of perivenous support.",
keywords = "Biopsy, Needle, Coronary Artery Bypass, Coronary Disease, Endothelium, Vascular, Female, Fibrin Tissue Adhesive, Graft Rejection, Humans, Immunohistochemistry, Leg, Male, Preoperative Care, Pressure, Saphenous Vein, Sensitivity and Specificity, Vascular Patency, Journal Article, Research Support, Non-U.S. Gov't",
author = "Wim Stooker and Murat G{\"o}k and Pieter Sipkema and Niessen, {Hans W M} and Alexi Baidoshvili and Nico Westerhof and Jansen, {Evert K} and Wildevuur, {Charles R H} and L{\'e}on Eijsman",
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Stooker, W, Gök, M, Sipkema, P, Niessen, HWM, Baidoshvili, A, Westerhof, N, Jansen, EK, Wildevuur, CRH & Eijsman, L 2003, 'Pressure-diameter relationship in the human greater saphenous vein' The Annals of Thoracic Surgery, vol. 76, no. 5, pp. 1533-8.

Pressure-diameter relationship in the human greater saphenous vein. / Stooker, Wim; Gök, Murat; Sipkema, Pieter; Niessen, Hans W M; Baidoshvili, Alexi; Westerhof, Nico; Jansen, Evert K; Wildevuur, Charles R H; Eijsman, Léon.

In: The Annals of Thoracic Surgery, Vol. 76, No. 5, 11.2003, p. 1533-8.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Pressure-diameter relationship in the human greater saphenous vein

AU - Stooker, Wim

AU - Gök, Murat

AU - Sipkema, Pieter

AU - Niessen, Hans W M

AU - Baidoshvili, Alexi

AU - Westerhof, Nico

AU - Jansen, Evert K

AU - Wildevuur, Charles R H

AU - Eijsman, Léon

PY - 2003/11

Y1 - 2003/11

N2 - BACKGROUND: Compliance of artificial and autologous vascular grafts is related to future patency. We investigated whether differences in compliance exist between saphenous vein grafts derived from the upper or lower leg, which might indicate upper or lower leg saphenous vein preference in coronary artery bypass surgery. Furthermore, the effect of perivenous application of fibrin glue on mechanical vein wall properties was studied to evaluate its possible use as perivenous graft support.METHODS: Vein segments (N = 10) from upper or lower leg saphenous vein grafts were collected for histopathologic examination and smooth muscle cell/extracellular matrix (SMC/ECM) ratio was calculated. This ratio is suggested to be related with vascular elastic compliance. In a second group vein graft segments (N = 6) from upper and lower leg were placed in an in vitro model generating stepwise increasing static pressure up to 150 cm H(2)O. Outer diameter was measured continuously with a video micrometer system. Distensibility was calculated from the pressure-diameter curves. A third group of vein graft segments (N = 7) was pressurized after fibrin glue application to prevent overdistension, and studied in the same setup.RESULTS: Vein segments from the lower leg demonstrated a consistent higher relative response compared with the upper leg saphenous vein graft (0.9176 +/- 0.03993 vs 0.5245 +/- 0.02512). Both reach a plateau in the high-pressure range (> 100 cm H(2)O). A significant difference in in vitro distensibility between upper and lower leg saphenous vein was only found at a pressure of 50 cm H(2)O (p < 0.05). With fibrin glue, support overdistension is prevented as revealed by the maximum relative response between fibrin glue supported upper and lower leg saphenous vein segments (0.4080 +/- 0.02464 vs 0.582 +/- 0.051), and no plateau is reached in the pressure range up to 150 cm H(2)O.CONCLUSIONS: No upper or lower leg saphenous vein preference could be deduced from the differences in pressure-diameter response due to loss of distensibility (and thus of compliance) in the high-pressure range. Fibrin glue effectively prevents overdistension and preserves some distensibility in the high-pressure range in both the upper and lower leg saphenous vein. This might provide a basis for clinical application of perivenous support.

AB - BACKGROUND: Compliance of artificial and autologous vascular grafts is related to future patency. We investigated whether differences in compliance exist between saphenous vein grafts derived from the upper or lower leg, which might indicate upper or lower leg saphenous vein preference in coronary artery bypass surgery. Furthermore, the effect of perivenous application of fibrin glue on mechanical vein wall properties was studied to evaluate its possible use as perivenous graft support.METHODS: Vein segments (N = 10) from upper or lower leg saphenous vein grafts were collected for histopathologic examination and smooth muscle cell/extracellular matrix (SMC/ECM) ratio was calculated. This ratio is suggested to be related with vascular elastic compliance. In a second group vein graft segments (N = 6) from upper and lower leg were placed in an in vitro model generating stepwise increasing static pressure up to 150 cm H(2)O. Outer diameter was measured continuously with a video micrometer system. Distensibility was calculated from the pressure-diameter curves. A third group of vein graft segments (N = 7) was pressurized after fibrin glue application to prevent overdistension, and studied in the same setup.RESULTS: Vein segments from the lower leg demonstrated a consistent higher relative response compared with the upper leg saphenous vein graft (0.9176 +/- 0.03993 vs 0.5245 +/- 0.02512). Both reach a plateau in the high-pressure range (> 100 cm H(2)O). A significant difference in in vitro distensibility between upper and lower leg saphenous vein was only found at a pressure of 50 cm H(2)O (p < 0.05). With fibrin glue, support overdistension is prevented as revealed by the maximum relative response between fibrin glue supported upper and lower leg saphenous vein segments (0.4080 +/- 0.02464 vs 0.582 +/- 0.051), and no plateau is reached in the pressure range up to 150 cm H(2)O.CONCLUSIONS: No upper or lower leg saphenous vein preference could be deduced from the differences in pressure-diameter response due to loss of distensibility (and thus of compliance) in the high-pressure range. Fibrin glue effectively prevents overdistension and preserves some distensibility in the high-pressure range in both the upper and lower leg saphenous vein. This might provide a basis for clinical application of perivenous support.

KW - Biopsy, Needle

KW - Coronary Artery Bypass

KW - Coronary Disease

KW - Endothelium, Vascular

KW - Female

KW - Fibrin Tissue Adhesive

KW - Graft Rejection

KW - Humans

KW - Immunohistochemistry

KW - Leg

KW - Male

KW - Preoperative Care

KW - Pressure

KW - Saphenous Vein

KW - Sensitivity and Specificity

KW - Vascular Patency

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Article

VL - 76

SP - 1533

EP - 1538

JO - The Annals of Thoracic Surgery

JF - The Annals of Thoracic Surgery

SN - 0003-4975

IS - 5

ER -