Biomechanical properties of different segments of human umbilical cord vein and its value for clinical application.

No satisfactory effects have been obtained with the use of synthetic blood vessels (diameter <6 mm) as substitutes for human small arteries or veins for the purpose of clinical vascular reconstruction. Therefore, blood vessels of human origin, for example, umbilical cord blood vessels, with their wide availability, still should be considered. However, little information on biomechanical properties of human umbilical cord blood vessels is available. The objective was to provide a theoretical basis for the clinical application of umbilical cord veins as optional material for small-caliber grafts. This was a nonrandomized, noncontrolled in vitro study. The experiment was conducted in the Laboratory of Medical Biomechanics, Yunyang Medical College. Umbilical cord veins of 20 normal fetuses of spontaneous labor were collected by the Department of Obstetrics and Gynecology, Taihe Hospital in Shiyan City, Hubei Province. The fetuses aged 37-40 weeks, and the parturients were 20-30 years old. Umbilical cord veins of the 20 fetuses were used and the placental ends were treated as proximal ends while the fetal ends as distal ends. The fetal ends were divided into three segments: proximal, middle, and distal segments. The relationship between pressure of umbilical cord veins segments and the diameters was measured on the biomechanical experiment stand for soft tissues, and then the elastic modulus was calculated. The materials were transversely extracted, refrigerated, and sliced up before HE staining. The geometrical morphology indexes were measured by a computer image analysis system (Leica-Q500IW). The main outcome measures were: incremental elastic modulus (E(inc)), pressure-strain elastic modulus (E(p)), volume elastic modulus (E(v)), diameter, and wall thickness of the veins. E(inc), E(p), and E(v) of umbilical cord veins of proximal, middle, and distal segments increased with the pressure elevated. The three kinds of elastic modulus of proximal segments (E(inc): 26.98 +/- 3.21, E(p): 16.58 +/- 2.12, E(v): 8.31 +/- 2.35) were all lower than those of distal segments (E(inc): 33.20 +/- 4.21, E(p): 119.45 +/- 2.87, E(v): 9.71 +/- 1.32) (F = 95.74-126.52, p < 0.05), and a tendency to increase was shown from proximal segments to distal segments. Media thickness [(0.30 +/- 0.05)] mm, (0.24 +/- 0.03) mm] and the diameters [(3.07 +/- 0.12) mm, (2.30 +/- 0.13) mm] decreased gradually from proximal to distal segments (F = 12.76, p < 0.01). It is feasible to use umbilical cord veins as substitutes for the transplantation of small-caliber arteries in terms of basic biomechanical properties. On vascular grafting, different segments of umbilical cord veins should be chosen cautiously so that the biomechanical characteristics of umbilical cord vein grafts could be in accordance with those of host to increase the long-term patency rate of transplanted blood vessels.