Could cryosurgery harvested veins be used as grafts? An immunohistochemical analysis of the morphology and viability of venous samples obtained by cryostripping

BACKGROUND: Cryosurgery is a feasible procedure for varicose veins removal, but the suitability of this method in harvesting venous grafts remains a subject of investigation. The aim of this study was to evaluate if cryostripping harvested veins remain viable in order be used as grafts.METHODS: One hundred nine venous samples harvested by cryostripping from 109 different patients operated for chronic venous disease were included in the study. Each specimen was subsequently divided in 6 samples. One sample was directly fixed in formalin, the others being maintained in saline solution for two, four, twelve, twenty-for and forty-eight hours, then fixed. For each case, all the 6 samples were microscopically analyzed then in both immunohistochemical stains, CD34 and Ki67, in order to establish the viability of the specimen in time.RESULTS: Immunoreactivity for CD34 was discernible across all three layers of the vein walls. Notably, the endothelial cell layer exhibited intense and uniform positivity in 36 out of the 109 samples under investigation. In contrast, the results regarding Ki67 expression remain inconclusive.CONCLUSIONS: Our results advocate for the utilization of CD34 as a reliable marker to assess the morphological and molecular integrity of excised venous specimens, which seems to preserve their viability for transplantation within 24-48 hours. This research contributes valuable insights and open new avenues for further exploration in the field of reconstructive, vascular and cardiac surgery.