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Effects of the novel polymer gel LeGooTM on human internal thoracic arteries
Bernhard Winkler1, Else Müller Schweinitzer, MD2, Faik Elezi, MD3, Grussenmeyer Thomas, PhD4, Florian Rueter, MD3, Matt Peter, MD3, Konerding Moritz, MD5, Grapow Martin, MD3, Eckstein Friedrich, MD3.
1University Hospital Basel, Basel, Switzerland, 2University Hospital Basel DBM Cardiac Surgery, Basel, Switzerland, 3University Hospital Basel Cardiac Surgery, Basel, Switzerland, 4University Hospital Basel DBM, Basel, Switzerland, 5University Mainz Anatomy, Mainz, Germany.
Background. Several established hemostatic devices enable performing vascular anastomosis in a blood free environment but existing methods can harm the vessel integrity leading to endothelial denudation or plaque rupture. LeGoo™ (Pluromed, Woburn, MA), is a novel poloxamer gel with reverse thermo-sensitive properties that can be used for temporary occlusion of blood vessels and facilitating anastomoses during bypass surgery. Aim of the present study was to investigate the effect of LeGooTM on vascular function and integrity of the human endothelium.
Methods. About 3 cm of the distal end of the internal thoracic artery was separated by a clamp, 1 cm was taken as control and LeGoo™ injected into the remaining part to be dissolved 10 minutes later by applying ice directly to the artery. Vascular function of both control and LeGoo™-applied segments was determined in organ bath experiments. Further samples were stored to be investigated using scanning electron microscopy.
Results. Following LeGoo™ application both maximal contractile responses to noradrenaline and endothelium-dependent relaxant responses to acetylcholine were significantly reduced. Elimination of endogenous relaxant mechanisms (i.e., noradrenaline uptake, beta-adrenoceptors and endogenous prostaglandin synthesis) reversed these changes partially. Scanning electron microscopic findings were in line with the functional changes.
Conclusion. The present data suggests that application of LeGoo™ induced mild endothelial injury and certain functional deterioration to the smooth muscle in human ITA.
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