Introduction:

energy sealing devices achieve hemostasis of the vessels through the heat generated and coagulation of the vascular wall proteins. However, the mid-term efficacy peofile for venous graft sealing in arterial bypass surgery remains unknown.

Objectives:

to create an animal model to compare the mid-term efficacy and safety profile at the sealing area after the healing process. To compare and assess which in vivo arterial models show lower morbidity and higher survival rates after 4 weeks.

Material and methods:

this was an in vivo experimental study of 16 New Zealand rabbits. In each rabbit a human saphenous vein (SV) with, at least, 1 venous collateral was implanted. Two arterial models were developed: infrarrenal aorta bypass with SV (n = 5) and aortoplasty with SV patch (n = 11). In both models the collateral was randomized and sealed with either 1 these 2 energy sealing devices: electrothermal Bipolar Vessel Sealing (EBVS) or Harmonic scalpel (HS). Every animal was treated with antithrombotic prophylaxis and immunosuppressive medication. The rates of intraoperative mortality, paraplegia, infection, bleeding, and survival were all studied.

Results:

two animals (50 %) survive 7 days after surgery in the bypass model. However, no animal survived 4 days after surgery in this model. In the aortoplasty group, the 7-day survival rate was 55.56 % (5/9) while the 4-week survival rate was 44.44 % (4/9) (p = 0.05). The rte of paraplegia was 100 % for the bypass model and much lower for the patch group (25 %) (p = 0.03). The mean ischemic time was lower for the aortoplasty model (37.11 min ± 8.1 min) compared to the bypass group (42 min ± 10.61 min) (p = 0.414). No animal showed intrabdominal hemorrhages or adverse drug reactions associated with the immunosuppressive medication.

Conclusion:

aortoplasty with the SV patch model showed lower rates of paraplegia and 7-day mortality in the animal model. Both the bypass and the path model models proved effective at the sealing area. However, only in the aortoplasty model 4 animals survived after 4 weeks.

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