Healing process in anastomosis of homologous venous grafts preserved in glutaraldehyde implanted aorta of rabbits R. MOURA 1 , W. B. YOSHIDA 1 , V. E. FABRIS 2 , A. Y. O. ANGELELI 3 , L. E. NARESSE 1 , F. H. A. MAFFEI 1 1 Department of Surgery and Orthopedics, School of Medicine of Paulista State University, Botucatu, São Paulo, Brazil 2 Department of Pathology, School of Medicine of Paulista State University, Botucatu, São Paulo, Brazil 3 Department of Medicine, School of Medicine of Paulista State University, Botucatu, São Paulo, Brazil Aim. Autologous vein (AV) is sometimes not suitable or present for a vascular restoration. Homologous vein pre- served in glutaraldehyde may be an alternative to AV, but little is yet known about this graft and its healing process after implantation in arteries. The purpose of this study was to compare the initial healing process of glutaralde- hyde-tanned homologous venous grafts (group 1) with fresh autologous venous grafts (group 2), at 4 or 15 days. Methods. Forty Norfolk rabbits were allocated in 2 groups of 20 animals each. The grafts was interposed in the infra- renal aorta of the rabbit. Anastomotic tensile strength (TS), hydroxyproline (HP) determination, and histology (HA) were performed. Results. TS increased in both groups, from the 4 th to 15 th day, (p<0.01) in both proximal (G1: from 364.5±98.3 g to 491.8±107.3 g; G2: from 366.26±85.15 g to 518.46±82.79 g) and distal anastomosis (G1: from 363.53±96.26 g to 507.32±91.01 g; G2: from 352.30±102.41 g to 528.67±48.58 g), with no difference between the groups. HP did not change (p>0.10) in this same period and was similar in both groups, in the proximal (G1: from 677.99±153.98 μg/100 mg to 914.92±459.83 μg/100 mg; G2: from 668.65±170.28 μg/100 mg to 669.46±319.80 ug/100 mg) as well as in the distal anas- tomosis (G1: from 740.07±213.53 μg/100 mg to 923.52±270.57 μg/100 mg; G2: from 737.66±266.76 μg/100 mg to 707.68±171.25 μg/100 mg). Initial inflammatory and repar- ative features of the anastomosis were similar in both groups. Conclusion. We can conclude that the healing process of the glutaraldehyde-tanned homologous vein graft was sim- ilar to that of the fresh autologous venous graft. [Int Angiol 2003;22:134-40] Key words: Wound healing - Veins - Glutaral - Rabbits - Bio- prosthesis - Tensile strength - Hydroxyproline. Bypass grafting is a common procedure in arte- rial surgery. Aorta and iliac arteries, as well as superficial femoral arteries can be successfully bypassed with synthetic grafts; 1, 2 however, for dis- tal bypasses, the autologous saphenous vein is the most reliable alternative and its use is only limit- ed by the small caliber of the vein, by varicosities or when it has been previously employed for another bypass procedure. 2 Among biological alternatives, one that has been extensively studied with good results is the pre- served homologous umbilical vein. 3, 4 Another type of biological preserved graft that was also tested is the human homologous saphenous vein pre- served in liquid nitrogen (cryopreservation) or tanned in different substances. 2, 5, 6 Glutaralde- hyde-tanned human saphenous veins have already been used with good results in selected patients with critical ischemia. 7 The patency rates obtained after 6 months of follow-up was 68%, with an 80% limb salvage and without calcification or dilata- tions shown by duplex scan. 7 Similar results were also observed in a few patients operated on in our Hospital. However, questions regarding the healing pro- cess of the grafts, the tensile or breaking strength and the collagen deposition in the anastomotic areas remain unanswered. A literature consensus suggests that the process follows the usual sequence of healing of tissue subjected to surgery in general. 7-14 This process begins with an acute inflammatory phase, followed by the release of chemical mediators, such as kinines, that promote dilation of the vessel, followed by the arrival of leukocytes. The adherence of leukocytes in the endothelium is associated to the release of C3a, C5a, prostacyclines, leukotrienes (C4, D4, E4), and lysosome that also participate actively in this inflammatory healing phase. 15-18 After the 3 rd day, there follows a prolific phase during which the fibroblasts responsible for the Presented at the “17 th World Congress of the International Union of Angiology” (London, UK, April 3-7, 1995). Received August 20, 2001; sent for revision November 15, 2001; accepted for publication April 15, 2002. 134 INTERNA TIONAL ANGIOLOGY June 2003 MINERVA MEDICA COPYRIGHT®