In vitro model to assess energy devices for the sealing of saphenous vein collaterals in revascularization surgery
| Autor: | Espinola, MF, Garcia, LR, Andani, EP, Nevarez, MIS, Ferrer, NR, Hernandez, MM |
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| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Angiología r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 0003-3170 |
| Popis: | Introduction: energy sealing devices achieve hemostasis of the blood vessels through sequential coagulation and transection. Objectives: to compare the efficacy of the main sealing devices used (Electrothermal Bipolar Tissue Sealing System [EB] and Harmonic Scalpel [HS]) versus conventional vessel ligation of saphenous vein (SV) collaterals. Material and methods: experimental in vitro study of 25 fragments of SV extracted from cadaveric donor, from residual fragments obtained during amputation or lower limb revascularization procedures. Two venous collateral seals were made on each fragment, one by conventional ligation with 3/0 silk (control) and the other one by EB (n = 13) or HS (n = 12). Each venous fragment was then incorporated into a pulsatile flow circuit, and the pressure was progressively increased until 300 mmHg (supraphysiological pressure) was reached, and, later on, until sealing breakage occurred. Collateral vein diameter, burst pressure, and leakage points were recorded. A histological study was also performed for each energy sealing device. Results: the mean burst pressure was slightly higher for EB (788,9 +/- 455 mmHg) than for HS (602,5 +/- 363,1 mmHg), but without significant differences (p = 0,268). Only in one case (HS) the outbreak occurred in the sealing zone at pressures below 300 mmHg. The leakage point for HS was detected in the sealing zone in all cases (12/12). The leakage point for EB occurred in the sealing zone in 8 of 13 fragments (p = 0,039). The histological study showed no differences. Conclusions: Vessel sealing devices are as effective for the sealing of saphenous vein collaterals as conventional ligation. These devices may be useful due to their fast sealing time and easy handling during surgical venous graft preparation for lower limb revascularization. Although the EB showed greater strength, the outbreak occurred at supraphysiological pressure, so this fact may not have clinical relevance. |
| Databáze: | OpenAIRE |
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