Fibrin Glue as External Support Prevents Vein Graft Early Injury

OBJECTIVE To investigate the effect of fibrin glue on preventing vein graft failure as perivenous application and explore a novel alternative external support.METHODS 24 New Zealand male rabbits were divided into non-supported group(NS group)(n=12) and fibrin glue group(FS group)(n=12).All animals underwent unilateral jugular vein into common carotid artery interposition grafting and then fibrin glue was applied as perivenous support.Samples of tissues were harvested after 4 weeks and histological and immunohistochemical analysis were underwent.RESULTS Compared with NS group,an obvious relief of ultramicrostructure were showed in vein grafts of FS group.The vein grafts with perivenous support by fibrin glue demonstrated a statistically decrease in neointimal and medial hyperplasia compared with non-supported vein grafts(P0.01).Immunohistochemical analysis showed that the expression of proliferating cell nuclear antigen(PCNA) was inhibited significantly in FS group compared with NS group.Almost intact endothelium was showed in FS grafts(P0.01).But in NS grafts there were severe endothelium damages where lymphocytes infiltrated.In NS grafts,the smooth muscle cells were hyperplasia and migrated to intimal,whereas in FS group,the hyperplasia of smooth muscle cells were inhibited and migrated to adventitia.We also observed the FS grafts were associated with a profound network of matured microvessels,but in NS grafts they were far less numerous.CONCLUSION Perivenous application of fibrin glue has beneficial effects on lessening early injury of vein grafts.These effects are related to intact endothelium,inhibition of PCNA expression,adventitial migration of SMC and formation of numerous microvessels.