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Perivenous application of fibrin glue reduces early injury of the human saphenous vein graft wall in an ex vivo model

Perivenous application of fibrin glue reduces early injury of the human saphenous vein graft wall... Stooker et al. [1] reported on a really interesting experiment, which of course provided some important data. They stated that perivenous support of human saphenous vein graft segments with fibrin glue in an ex vivo model can attenuate severe injury when exposed to arterial pressure. Interestingly, they reported on a complete loss of endothelial cells within non-supported or native vein graft segments when exposed to pulsatile as well as non-pulsatile arterial flow generated by an extracorporeal bypass circuit. It is hard to believe that not only small portions, but all endothelial cells get lost under such conditions. Complete de-endothelialization is associated with strong thrombogenicity. Thus, one would expect more stenotic/closed venous grafts following CABG surgery. Can we put this in a logical cue with our current results following these interventions? Furthermore, Stooker et al. [1] stated that CD34 was chosen for the identification of endothelial cell coverage and described supported vein segments to be positive and non-supported to be negative for this adhesion molecule. CD34 is an endothelial cell surface marker expressed on endothelial progenitor cells [2]. After differentiation under natural conditions it shows no or only slightly positive expression [3]. However, an at least theoretical explanation for positive staining could be the migration of CD34 positive cells, as it is described that CD34 positive cells are mobilized during an acute ischemic event [4,5]. Thus, non-visible CD34 expression does not exclude the presence of endothelial cells, and visible CD34 expression on native vein segments could be explained by many factors, e.g. inflammatory endothelial reaction or cell migration as mentioned above. Both these conditions are very unlikely, as the duration of the described experiment was probably too short to establish these events. Thus, although CD31 staining methods have not been performed to exclude false positive results originating from platelets, which attach to the extracellular matrix molecules after endothelial cell loss, the authors should think about CD31 and other methods for the characterization of full differentiated endothelial cells as well. References [1] Stooker W. , Niessen H.W.M. , Wildevuur W.R. , van Hinsbergh V.W.M. , Fritz J. , Jansen E.K. , Wildevuur C.R.H. , Eijsman L. . Perivenous application of fibrin glue reduces early injury of the human saphenous vein graft wall in an ex vivo model , Eur J Cardiovasc Surg , 2002 , vol. 21 (pg. 212 - 217 ) Google Scholar Crossref Search ADS WorldCat [2] Murohara T. , Ikeda H. , Duan J. , Shintani S. , Sasaki K. , Eguchi H. , Onitsuka I. , Matsui K. , Imaizumi T. . Transplanted cord blood-derived endothelial precursor cells augment postnatal neovascularization , J Clin Invest , 2000 , vol. 105 11 (pg. 1527 - 1536 ) Google Scholar Crossref Search ADS PubMed WorldCat [3] Korff T. , Kimmina S. , Martiny-Baron G. , Augustin H.G. . Blood vessel maturation in a 3-dimensional saphenoidal coculture model: direct contact with smooth muscle cells regulates endothelial cell quiescence and abrogates VEGF responsiveness , Fed Am Soc Exp Biol J , 2001 , vol. 15 2 (pg. 447 - 457 ) OpenURL Placeholder Text WorldCat [4] Shintani S. , Murohara T. , Ikeda H. , Ueno T. , Honma T. , Katoh A. , Sasaki K. , Shimada T. , Oike Y. , Imaizumi T. . Mobilization of endothelial progenitor cells in patients with acute myocardial infarction , Circulation , 2001 , vol. 103 23 (pg. 2776 - 2779 ) Google Scholar Crossref Search ADS PubMed WorldCat [5] Takahashi T. , Kalka C. , Masuda H. , Chen D. , Silver M. , Kearney M. , Maagner M. , Isner J.M. , Asahara T. . Ischemia- and cytokine-induced mobilization of bone marrow derived endothelial progenitor cells for neovascularization , Nat Med , 1999 , vol. 5 4 (pg. 434 - 438 ) Google Scholar Crossref Search ADS PubMed WorldCat © 2002 Elsevier Science B.V. All rights reserved Elsevier Science B.V. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press

Perivenous application of fibrin glue reduces early injury of the human saphenous vein graft wall in an ex vivo model

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References (5)

Publisher
Oxford University Press
Copyright
© 2002 Elsevier Science B.V. All rights reserved
Subject
Letter to the Editor
ISSN
1010-7940
eISSN
1873-734X
DOI
10.1016/S1010-7940(02)00347-0
Publisher site
See Article on Publisher Site

Abstract

Stooker et al. [1] reported on a really interesting experiment, which of course provided some important data. They stated that perivenous support of human saphenous vein graft segments with fibrin glue in an ex vivo model can attenuate severe injury when exposed to arterial pressure. Interestingly, they reported on a complete loss of endothelial cells within non-supported or native vein graft segments when exposed to pulsatile as well as non-pulsatile arterial flow generated by an extracorporeal bypass circuit. It is hard to believe that not only small portions, but all endothelial cells get lost under such conditions. Complete de-endothelialization is associated with strong thrombogenicity. Thus, one would expect more stenotic/closed venous grafts following CABG surgery. Can we put this in a logical cue with our current results following these interventions? Furthermore, Stooker et al. [1] stated that CD34 was chosen for the identification of endothelial cell coverage and described supported vein segments to be positive and non-supported to be negative for this adhesion molecule. CD34 is an endothelial cell surface marker expressed on endothelial progenitor cells [2]. After differentiation under natural conditions it shows no or only slightly positive expression [3]. However, an at least theoretical explanation for positive staining could be the migration of CD34 positive cells, as it is described that CD34 positive cells are mobilized during an acute ischemic event [4,5]. Thus, non-visible CD34 expression does not exclude the presence of endothelial cells, and visible CD34 expression on native vein segments could be explained by many factors, e.g. inflammatory endothelial reaction or cell migration as mentioned above. Both these conditions are very unlikely, as the duration of the described experiment was probably too short to establish these events. Thus, although CD31 staining methods have not been performed to exclude false positive results originating from platelets, which attach to the extracellular matrix molecules after endothelial cell loss, the authors should think about CD31 and other methods for the characterization of full differentiated endothelial cells as well. References [1] Stooker W. , Niessen H.W.M. , Wildevuur W.R. , van Hinsbergh V.W.M. , Fritz J. , Jansen E.K. , Wildevuur C.R.H. , Eijsman L. . Perivenous application of fibrin glue reduces early injury of the human saphenous vein graft wall in an ex vivo model , Eur J Cardiovasc Surg , 2002 , vol. 21 (pg. 212 - 217 ) Google Scholar Crossref Search ADS WorldCat [2] Murohara T. , Ikeda H. , Duan J. , Shintani S. , Sasaki K. , Eguchi H. , Onitsuka I. , Matsui K. , Imaizumi T. . Transplanted cord blood-derived endothelial precursor cells augment postnatal neovascularization , J Clin Invest , 2000 , vol. 105 11 (pg. 1527 - 1536 ) Google Scholar Crossref Search ADS PubMed WorldCat [3] Korff T. , Kimmina S. , Martiny-Baron G. , Augustin H.G. . Blood vessel maturation in a 3-dimensional saphenoidal coculture model: direct contact with smooth muscle cells regulates endothelial cell quiescence and abrogates VEGF responsiveness , Fed Am Soc Exp Biol J , 2001 , vol. 15 2 (pg. 447 - 457 ) OpenURL Placeholder Text WorldCat [4] Shintani S. , Murohara T. , Ikeda H. , Ueno T. , Honma T. , Katoh A. , Sasaki K. , Shimada T. , Oike Y. , Imaizumi T. . Mobilization of endothelial progenitor cells in patients with acute myocardial infarction , Circulation , 2001 , vol. 103 23 (pg. 2776 - 2779 ) Google Scholar Crossref Search ADS PubMed WorldCat [5] Takahashi T. , Kalka C. , Masuda H. , Chen D. , Silver M. , Kearney M. , Maagner M. , Isner J.M. , Asahara T. . Ischemia- and cytokine-induced mobilization of bone marrow derived endothelial progenitor cells for neovascularization , Nat Med , 1999 , vol. 5 4 (pg. 434 - 438 ) Google Scholar Crossref Search ADS PubMed WorldCat © 2002 Elsevier Science B.V. All rights reserved Elsevier Science B.V.

Journal

European Journal of Cardio-Thoracic Surgery – Oxford University Press

Published: Sep 1, 2002

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