Abstract
Background
Bipolar energy ligation of vessels in surgery is common. Although rare, serious failures
occur. Atherosclerosis may contribute to seal failures by altering vascular compressibility
and collagen content; however, no data exist.
Materials and methods
Femoral and iliac arteries of six Yucatan swine with an identified genetic locus predisposing
them to atherosclerosis were denuded with a Fogarty catheter. Animals were fed a high-fat
diet for 28 wk. A Yorkshire pig was used as a normal control and fed a standard diet.
At 28 wk, arteries were measured for their diameters, sealed, and divided in vivo with LigaSure. The sealed artery sections were excised and subjected to burst pressure
testing. Half of the seal distal to the aorta was kept intact for histology and collagen
and elastin quantification. A multiple linear regression model was used to assess
variables contributing to burst pressure. Covariates included were vessel diameter,
degree of atherosclerosis, and collagen content.
Results
Experimental animals were hypercholesterolemic. Atherosclerosis occurred in 90% of
seals in induced animals, with severe atherosclerosis in 62% of seals. There was site-selective
deposition of atherosclerotic plaques in larger diameter iliac vessels. A model including
collagen and size best predicted burst pressure. Every 10-U increase in collagen resulted
in 15% increase in burst pressure (95% confidence interval = 0.2%–32%, P = 0.047, R2 = 0.36). Atherosclerosis was unrelated to burst pressure controlling for collagen
and size.
Conclusions
Collagen and size provide the best model fit for predicting burst pressure. Quantitative
research in human vasculature is warranted to better understand the influence of atherosclerosis
and collagen content on seal failures.
Keywords
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Article info
Publication history
Published online: July 08, 2013
Accepted:
June 12,
2013
Received in revised form:
May 28,
2013
Received:
April 23,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
