İhsan Alur1, Yavuz Dodurga2, Tevfik Güneş1, Canan Eroglu2, Fırat Durna3, Nilay Şen Türk4, Esat Adıgüzel5, Bilgin Emrecan1. 1. Department of Cardiovascular Surgery, Faculty of Medicine, Pamukkale University Denizli, Turkey. 2. Department of Medical Biology and Genetics, Faculty of Medicine, Pamukkale University Denizli, Turkey. 3. Department of Cardiovascular Surgery, Nigde State Hospital Nigde, Türkiye. 4. Department of Pathology, Faculty of Medicine, Pamukkale University Denizli, Turkey. 5. Department of Anatomy, Faculty of Medicine, Pamukkale University Denizli, Turkey.
Abstract
BACKGROUND:Endovenous laser ablation (EVLA) is a treatment option for lower extremity varicose veins. In the present study, we investigate to the genetic changes and possibility of living tissue in the saphenous vein wall after the EVLA procedure. METHODS:Eleven saphenous vein grafts were randomized in two groups: (1) 4 cm SVG segments of performed EVLA procedure in study group, (2) 4 cm segments of SVG none performed EVLA procedure in control group. SVG were taken from the remnants of distal saphenous vein grafts prepared for the bypass procedure but not used. SVG was approximately 8 cm in length and was divided into two parts 4 cm in length. One half was exposed to laser energy, while the other half of the same vein graft was untreated as a control. EVLA was performed on complete saphenous veins in the study group. Abnormal genetic changes of the SVG were observed with a Tri-Reagent method and quantified with a Nanodrop™ spectrophotometer. RESULTS:Histopathological changes indicated that the intima including the endothelium was completely necrotized in the study group. It was observed that intimal thermal-energy-induced injury did not reach the media. Histopathological examination showed that homogenous eosinophilic discoloration and coagulation necrosis characterized the laser related thermal damage as well. CONCLUSIONS: In this preliminary study, we found that living tissue remained in the SVG wall after application of laser ablation, and we also detected abnormal genetic changes in the study group compared with the control group.
RCT Entities:
BACKGROUND: Endovenous laser ablation (EVLA) is a treatment option for lower extremity varicose veins. In the present study, we investigate to the genetic changes and possibility of living tissue in the saphenous vein wall after the EVLA procedure. METHODS: Eleven saphenous vein grafts were randomized in two groups: (1) 4 cm SVG segments of performed EVLA procedure in study group, (2) 4 cm segments of SVG none performed EVLA procedure in control group. SVG were taken from the remnants of distal saphenous vein grafts prepared for the bypass procedure but not used. SVG was approximately 8 cm in length and was divided into two parts 4 cm in length. One half was exposed to laser energy, while the other half of the same vein graft was untreated as a control. EVLA was performed on complete saphenous veins in the study group. Abnormal genetic changes of the SVG were observed with a Tri-Reagent method and quantified with a Nanodrop™ spectrophotometer. RESULTS: Histopathological changes indicated that the intima including the endothelium was completely necrotized in the study group. It was observed that intimal thermal-energy-induced injury did not reach the media. Histopathological examination showed that homogenous eosinophilic discoloration and coagulation necrosis characterized the laser related thermal damage as well. CONCLUSIONS: In this preliminary study, we found that living tissue remained in the SVG wall after application of laser ablation, and we also detected abnormal genetic changes in the study group compared with the control group.
Entities:
Keywords:
Endovenous laser ablation; apoptosis; genetic; living tissue
Authors: S Thomis; P Verbrugghe; R Milleret; E Verbeken; I Fourneau; P Herijgers Journal: Eur J Vasc Endovasc Surg Date: 2013-07-06 Impact factor: 7.069