Biochemical adaptation of venous patches placed in the carotid circulation
D. M. Govostis, D. F. Bandyk, T. M. Bergamini and J. B. Towne
Surgical Service, Veterans Administration Medical Center, Milwaukee, WI.
The influence of venous patching on luminal prostacyclin (PGI2) and
thromboxane A2 (TBX) production of endarterectomized arteries was studied
in a canine model. Fifteen dogs underwent bilateral common carotid
endarterectomies. In each dog, one artery was closed primarily and the
contralateral artery was closed by vein-patch angioplasty. At six and 12
weeks after operation, luminal prostanoid production from the venous patch,
adjacent endarterectomized artery, and control artery and vein was measured
by radioimmunoassay for 6-keto-prostaglandin F1 alpha and thromboxane B2.
Venous patches underwent "incomplete" biochemical adaptation with decreased
luminal production of PGI2 compared with control and endarterectomized
arteries. Thromboxane production from venous patches was increased compared
with normal vein but similar to control and endarterectomized arteries. At
six weeks, PGI2 production of vein-patched arterial segments was increased
compared with arteries closed primarily. These data indicate that
vein-patch angioplasty favorably influences surface thrombogenicity of
healing, endarterectomized arteries and support its use in reparative
carotid surgery.
