Biochemical Adaptation of Venous Patches Placed in the Carotid Circulation

Abstract

• The influence of venous patching on luminal prostacyclin (PGI₂) and thromboxane A₂ (TBX) production of endarterectomized arteries was studied in a canine model. Fifteen dogs underwent bilateral common carotid endarterectomies. In each dog, one artery was closed primarily and the contralateral artery was closed by vein-patch angioplasty. At six and 12 weeks after operation, luminal prostanoid production from the venous patch, adjacent endarterectomized artery, and control artery and vein was measured by radioimmunoassay for 6-keto-prostaglandin F_1α and thromboxane B₂. Venous patches underwent "incomplete" biochemical adaptation with decreased luminal production of PGI₂ compared with control and endarterectomized arteries. Thromboxane production from venous patches was increased compared with normal vein but similar to control and endarterectomized arteries. At six weeks, PGI₂ production of vein-patched arterial segments was increased compared with arteries closed primarily. These data indicate that vein-patch angioplasty favorably influences surface thrombogenicity of healing, endarterectomized arteries and support its use in reparative carotid surgery. (Arch Surg 1989;124:490-493)