The importance of endothelial cells in the course of vascular surgical interventions

Aorto-coronary bypass made by implanting the patient's own saphenous vein may exhibit a tendency to early and late occlusion. This phenomenon is influenced by a number of factors including intraoperative damages of the graft. To determine preferable techniques for preserving vein integrity, various human graft preparation techniques were compared. Endothelial damage may occur during the preparation of the saphenous vein; the extent of damage depends on the preparation technique. In our studies the endothelium was best preserved by Rheomacrodex filling at 100 water cm pressure. Early occlusion seems to be best avoided in certain conditions using Gore-tex (polytetrafluoro-ethylene) prostheses due to the fact that the structure of Gore-tex simulates the normal endothelium covering of the luminal surface of the vessels and renders quick "re" endothelialization. This may reduce the hazard of early graft occlusion. In the present study experimental models and grafts implanted in humans were compared and results were tested by scanning electron microscopy.