Key result
Saphenous vein exhibits ~3-fold greater longitudinal strength than umbilical vein for aortic bypass.
Why the study?
There is a lack of knowledge about the mechanical properties of human blood vessels used for CABG, especially human umbilical veins, which impacts long-term graft patency.
Human saphenous veins exhibit significantly higher stiffness and lower stretchability compared to umbilical veins, correlating with higher elastin and collagen content, which may influence their suitability as CABG conduits.
Vein stiffness differences merit caution in conduit choice; leaves open whether umbilical veins offer superior CABG performance in humans.
BACKGROUND: As a main cause of mortality in developed countries, Coronary Artery Disease (CAD) is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG) is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. METHODS: Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stress-strain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. RESULTS: Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous vein's stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. CONCLUSION: Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels' stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as rat aortic vessels. As blood vessel's stiffness is directly related to elastin and mainly collagen content, results showed the lower amount of these two contents in umbilical vein regarding Saphenous vein.
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Hamedani et al. (2012) studied Coronary Artery Bypass Graft (CABG) conduits (n=8). Human Umbilical Vein vs. Human Saphenous Vein was evaluated on Longitudinal ultimate strength (Cauchy stress in MPa). Human saphenous vein demonstrated substantially greater longitudinal ultimate strength (5.38 MPa) compared to human umbilical vein (1.65 MPa), suggesting umbilical vein is less suitable for aortic bypass.
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