Compliance and formation of distal anastomotic intimal hyperplasia in Dacron mesh tube constricted veins used as arterial bypass grafts.
Compliance and formation of distal anastomotic intimal hyperplasia in Dacron mesh tube constricted veins used as arterial bypass grafts.
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DOI：
10.1097/00002480-199407000-00007
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发表时间：
1994-07-01
期刊：
影响因子：
--
通讯作者：
Polterauer, P
中科院分区：
文献类型：
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作者：
Trubel, W;Moritz, A;Polterauer, P
扩张和曲张的静脉用涤纶网状管收缩成功地用作动脉旁路移植物，以避免非自体血管假体。网片收缩也用于使静脉移植物管腔适应移植动脉的直径。未研究外部网片对此类静脉移植物的壁弹性和宿主动脉反应的影响。在本实验中，研究了在股腘动脉重建中用作动脉移植物的网状收缩自体静脉的弹性特性，以及远端吻合口内膜增生（DAIH）的连续形成。将24个自体静脉移植物植入12只绵羊体内。移植物保持自然状态（第1组和第3组）或使用外部Dacron补片收缩（第2组和第4组）;其直径保持不变（第1组和第2组）或与宿主动脉直径匹配（第3组和第4组）。在手术和随访期间，通过局部应用晶体传感器测量移植物、远端吻合口和远端动脉的壁弹性。DAIH的形成和定位在平均8.3个月后进行组织形态学评价。发现网状管移植物的移植物壁弹性较低（54.6 vs. 147.9，P = 0.006），总DAIH较高（49.42 vs. 20.8 μ m，P = 0.001，Mann-Whitney U检验）。弹性和DAIH形成之间没有差异，观察移植物与适应和大直径。涤纶网状管对静脉移植物的收缩降低了移植物壁的弹性，促进了DAIH的形成。为了在利用该方法的优点的同时避免顺应性的这种增加的不匹配，外部网状管必须不靠近远端吻合区域本身。
Dilated and varicose veins constricted with a Dacron mesh tube were successfully used as arterial bypass grafts to avoid nonautogenous vascular prostheses. Mesh constriction has also been used to adapt the venous graft lumen to the diameters of grafted arteries. The influence of the external mesh on the wall elasticity of such venous grafts and the reactions of the host artery were not investigated. Elastic properties of mesh constricted autologous veins used as arterial grafts in femoropopliteal reconstructions, as well as consecutive formation of distal anastomotic intimal hyperplasia (DAIH), were investigated in this experiment. Twenty-four autologous venous grafts were implanted in 12 sheep. Grafts were left natural (Groups 1 and 3) or were constricted with an external Dacron mesh (Groups 2 and 4); their diameters were left unchanged (Groups 1 and 2) or were matched to the diameter of the host artery (Groups 3 and 4). Wall elasticity of the graft, distal anastomosis, and distal artery were measured by locally applied crystal transducers during surgery and follow-up. Formation and localization of DAIH was evaluated histomorphologically after a median of 8.3 months. Graft wall elasticity was found to be lower (54.6 vs. 147.9, P = 0.006) and overall DAIH was found to be higher in mesh tube grafts (49.42 vs. 20.8 microns, P = 0.001, Mann-Whitney U-test). No differences in elasticity and DAIH formation were observed between grafts with adapted and large diameters. Constriction of venous grafts by a Dacron mesh tube reduces graft wall elasticity and promotes formation of DAIH. To avoid such an increased mismatch in compliance while making use of the advantages of this method, the external mesh tube must not be brought close to the distal anastomotic area itself.