The effect of catheter use on vein grafting of a peripheral nerve defect: an experimental study

BACKGROUND
Since vein grafts have been used in the repair of nerve defects, studies regarding this procedure have accumulated, and after coming into clinical use, it was noticed that there is a problem of collapse in the vein graft.
METHODS
Forty Sprague-Dawley rats were used, divided into five groups. No surgical intervention was performed in the first group. The defect was created in the sciatic nerve in Group 2 and left unrepaired. In Group 3, the defect was repaired with a nerve graft. In Group 4, the defect was repaired with a vein graft, while in Group 5, the repair was performed using a vein graft with an inserted catheter. In order to evaluate functional recovery and nerve regeneration, walking track analysis, electrophysiologic and histomorphometric analyses were done at the end of the 12th week.
RESULTS
Although there were no functional differences between Groups 5 and 4, comparisons regarding nerve conduction velocity demonstrated that the results obtained in Group 5 were better than those in Group 4. When the number of axons on the distal part of the sciatic nerve and mid-segment of the repaired area was taken into account, no significant difference was found between Groups 3 and 5, whereas there was a significant difference between Groups 4 and 5.
CONCLUSION
In our study, it was experimentally shown that the problem of collapse of a vein graft occurring after its use in the reconstruction of a nerve defect can be overcome by placing a catheter into the vein graft. Consequently, this method may eliminate the need for the use of a nerve graft in selected cases.

Ven grefti ile periferik sinir defektlerinin onarýmýnda kateter kullanýmýnýn sinir rejenerasyonuna etkisi: Deneysel çalýþma

AMAÇ
Sinir defektlerinin rekonstrüksiyonunda ven greftlerinin kullanýlmasý ile ilgili çalýþmalarýn artmasý ve bu uygulamanýn klinikte kullanýma girmesiyle birlikte, ven greftinin kollabe olma sorununun ortaya çýktýðý görülmüþtür.
GEREÇ VE YÖNTEM
Çalýþmada 40 adet Spraque-Dawley sýçan kullanýldý. Beþ gruptan, 1. gruba herhangi bir cerrahi giriþim yapýlmadý; 2. grubun siyatik sinirinde oluþturulan defekt onarýlmadan býrakýldý, 3. grupta defekt sinir grefti ile onarýldý, 4. grupta defekt ven grefti ile 5. grupta ise ven grefti ve katater birlikte kullanýlarak onarým yapýldý. Birinci ve ikinci grup kontrol grubu olarak kullanýldý. Fonksiyonel iyileþmeyi, sinir rejenerasyonunu deðerlendirmek amacýyla, 12. haftanýn sonunda, yürüme analizi, elektrofizyolojik ve histomorfometrik analizler yapýldý.
BULGULAR
Defektin ven grefti ve katater ile onarýldýðý grup (grup 5) ile grup 3 ve 4 arasýnda fonksiyonel açýdan fark bulunmazken, sinir iletim hýzý açýsýndan bakýldýðýnda, 5. gruptaki sonuçlar, ven grefti ile onarým yapýlan gruptan (grup 4) daha iyi bulundu. Onarým distalinden ve onarým alanýnýn ortasýndan alýnan siyatik sinir kesitlerindeki akson sayýsýna bakýldýðýnda 3. ve 5. grup arasýnda fark bulunamazken; 4. ve 5. grup arasýndaki fark anlamlýydý.
SONUÇ
Bu çalýþma sonucunda, ven grefti ile onarýlan periferik sinir yaralanmalarýnda görülebilen ven grefti kollapsýnýn ven grefti içine kateter yerleþtirilmesi ile aþýlabileceði ve bu sayede onarýmda sinir grefti kullanma ihtiyacýnýn ortadan kalkabileceði deneysel olarak gösterilmiþtir.