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Localization of nitric oxide synthase in saphenous vein grafts harvested with a novel "no-touch" technique: potential role of nitric oxide contribution to improved early graft patency rates.
Departments of Surgery, Royal Free and University College Medical School, Royal Free Campus, London, United Kingdom.
Department of Thoracic and Cardiovascular Surgery, Örebro Medical Centre Hospital, Örebro, Sweden.
Department of Transfusion Medicine, Örebro Medical Centre Hospital, Örebro, Sweden.
Department of Histopathology, Örebro Medical Centre Hospital, Örebro, Sweden.ORCID iD: 0000-0001-6881-237X
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2002 (English)In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 35, no 2, 356-362 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The use of the saphenous vein in coronary artery bypass graft surgery is associated with high 1-year occlusion rates of as much as 30%. A new "no-touch" technique of saphenous vein harvesting in which the vein is harvested with a pedicle of surrounding tissue and not distended may result in improved early patency rates. We hypothesize that nitric oxide synthase is better preserved with the no-touch technique, and the aim of this study was the investigation of whether nitric oxide synthase distribution and quantity in saphenous veins harvested with the no-touch technique differ from those veins harvested with the conventional technique. The separate contribution of perivascular tissue removal and distension to alterations in nitric oxide synthase was also studied.

Methods: Segments of 10 saphenous veins were harvested from 10 patients who underwent coronary artery bypass grafting surgery with the no-touch and conventional techniques. Samples were also taken from segments that were stripped of surrounding tissue but not distended. Nitric oxide synthase distribution was studied with reduced nicotinamide adenine dinucleotide phosphate--diaphorase histochemistry, and staining was quantified with image analysis. Immunohistochemistry was used for the identification of specific nitric oxide synthase isoforms, and immunomarkers were used for the identification of associated cell types.

Results: Nitric oxide synthase content was higher in no-touch vessels as compared with conventionally harvested vessels (35.5%; P <.05, with analysis of variance). This content was associated with endothelial nitric oxide synthase on the lumen while all three isoforms were present in the media. In the intact adventitia of no-touch vessels, all three isoforms of nitric oxide synthase were also present, associated with microvessels and perivascular nerves. Perivascular tissue stripping and venous distension both contribute to the reduced nitric oxide synthase in conventionally harvested veins.

Conclusion: The new no-touch technique of saphenous vein harvesting preserves nitric oxide synthase, which suggests that improved nitric oxide availability may be an important mechanism in the success of this technique.

Place, publisher, year, edition, pages
New York, USA: Elsevier, 2002. Vol. 35, no 2, 356-362 p.
National Category
Cardiac and Cardiovascular Systems Clinical Laboratory Medicine Physiology
Identifiers
URN: urn:nbn:se:oru:diva-49516DOI: 10.1067/mva.2002.121072ISI: 000174126600022PubMedID: 11854735Scopus ID: 2-s2.0-0036482335OAI: oai:DiVA.org:oru-49516DiVA: diva2:914893
Available from: 2016-03-27 Created: 2016-03-25 Last updated: 2017-10-17Bibliographically approved

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