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Endothelial Response to Venous Injury
William Krupski, MD;
Erwin R. Thal, MD;
Bruce L. Gewertz, MD;
L. Maximilian Buja, MD;
Mark E. Murphy, PhD;
Herbert K. Hagler, PhD;
William J. Fry, MD
Arch Surg. 1979;114(11):1240-1248.
Abstract
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• This investigation characterized venous endothelial healing after surgical manipulation. Procedures were performed on jugular and femoral veins in 21 mongrel dogs without systemic anticoagulation. Veins were harvested at varying intervals and vessel structure evaluated with light, transmission, and scanning electron microscopy. Veins that were mobilized or stripped of adventitia demonstrated 25% to 50% endothelial loss at one hour. Endothelial damage was rapidly repaired with complete healing observed in some veins at 48 hours. Tourniquets and clamps resulted in prominent medial and endothelial injury at occlusion sites. Eighteen of 24 transected veins remained patent for the study period. Endothelial healing was unaffected by tension at anastomoses. These observations confirm that venous endothelium receives nutrition by luminal diffusion. The healing process of venous anastomoses is characterized by an early fibrin sleeve sealing the anastomotic site; endothelial bridging of defects can be noticeably delayed by excessive fibrin deposition.
(Arch Surg 114:1240-1248, 1979)
Author Affiliations
From the Department of Surgery (Drs Krupski, Thai, Gewertz, and Fry) and Pathology (Drs Buja, Murphy, and Hagler), University of Texas Health Sciences Center, Dallas.
Footnotes
Accepted for publication July 19, 1979.
Read before the 27th scientific meeting of the International Cardiovascular Society, Nashville, Tenn, June 28, 1979.
Reprint requests to Department of Surgery, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Thal).
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