Effects of carbon dioxide insufflation on anastomosis remodeling at a carotid artery site in rabbits

INTRODUCTION: Use of carbon dioxide (CO(2)) insufflation (CDI) on the surgical field during heart surgery has become widespread, and in some units routine. AIM: To assess the effects of CDI on endothelial dysfunction in a carotid artery model in rabbits. MATERIAL AND METHODS: Twelve randomly selected rabbits were divided into two groups. Right carotid arteries of the animals were transected and sutured with running suture technique. Then, 1 l/min CO(2) insufflation was initiated with a 45° angle. In the control group, the anastomotic field was irrigated with 0.1 ml/s flow of 0.9% saline. At day 28, the carotid artery segments were removed and prepared for histological specimens. RESULTS: In the cross-sections of the control group vessel samples, thickening of the tunica intima was observed. Scoring the quantity of endothelial nitric oxide synthase (e-NOS) and α-smooth muscle actin (α-SMA) positive staining revealed a nonsignificant difference between the experimental groups (p = 0.07). In the CO(2) group, the intimal hyperplasia (p = 0.2) and the thickness of the tunica media (p = 0.2) were indistinguishable when compared to the control group. The mean luminal diameters and luminal areas of the experimental groups were all evaluated by histomorphometry and a significant differences was found between luminal areas (p = 0.016). On the other hand, no significant difference was found between mean luminal diameters (p = 0.055). CONCLUSIONS: Our study indicated that CDI can affect endothelial cell damage and the mean luminal diameters.