Intercellular and vascular cell adhesion molecule levels in endoscopic andopen saphenous vein harvesting for coronary artery bypass surgery

BACKGROUND: Numbers of intercellular and vascular cell adhesion molecules ( ICAM and VCAM) and major ligands on endothelial cells for adherence of acti vated polymorphnuclear leukocytes, macrophages, and lymphoid cells increase in many inflammatory disorders and after trauma to different tissues. METHODS: Samples of human saphenous veins were harvested from 90 randomly s elected patients who underwent coronary artery bypass graft (CABG) surgery, utilizing two different techniques (open and endoscopic). Endothelial cell s were collected from the vein samples and cultured for 72 hours. Pre- and postoperative sera, in addition to the supernatants from the cultures, were analyzed for ICAM-1 and VCAM-1 using enzyme-linked immunosorbent assay. RESULTS: Mean preoperative levels of ICAM-1 and VCAM-1 (0.95 +/- 0.58 ng/mL and 1.81 +/- 1.03 ng/mL, respectively) did not differ significantly from t hat of postoperative sera (0.98 +/- 0.451 ng/mL and 1.74 +/- 1.05 ng/mL, re spectively) (p = 0.77 and p = 0.73, respectively). Mean ICAM-1 and VCAM-1 l evels in endothelial cell culture supernatants did not differ significantly between the endoscopic (0.16 +/- 0.05 ng/mL and 0.23 +/- 0.10 ng/mL, respe ctively) and the open method (0.18 +/- 0.08 ng/mL and 0.30 +/- 0.27 ng/mL, respectively) (p = 0.19 and 0.13, respectively). CONCLUSION: Our findings indicate that endoscopic and open saphenectomies a re technically comparable in their effects on ICAM-1 and VCAM-1 synthesis d uring saphenous vein harvesting for CABG. We recommend the endoscopic metho d for its low morbidity and earlier hospital discharge.