Immuno-pathophysiologic studies on the late occulusion of autovein bypass grafts in peripheral arterial reconstruction

采用免疫组织学和显微观察方法对犬股动脉远端端侧吻合处自体静脉旁路移植术的内膜增生情况进行了研究。在免疫组织学研究中，使用单时抗胶原I、III、IV抗体和抗纤维连接蛋白抗体。1)自体静脉移植物内膜增生的研究：自体静脉移植物在植入7天后腔腔表面被内皮样细胞完全覆盖。内皮样细胞ⅰ、ⅲ、ⅳ型胶原染色阳性，纤维连接蛋白染色阳性。2周时，静脉移植物表面有限的2-3层新生内膜ⅰ、ⅲ、ⅳ型胶原染色和纤维连接蛋白染色呈强阳性，与动脉内膜相似。2)端侧远端吻合端内膜增生的研究：植入术3个多月后，端侧吻合端趾部和足跟部内膜增生明显，伴有相当大的血管血管发育。吻合口增生性内膜ⅰ、ⅲ型胶原和纤维连接蛋白弥漫性阳性。III型胶原在浅层2-3层呈微阳性。综上所述，动脉植入自体静脉移植物的新内膜组织中胶原纤维与动脉内膜组织相似，但胶原纤维在远端端侧吻合的新内膜中增殖的情况不同于静脉移植物的新内膜和动脉内膜。

The fate of intimal hyperplasia of the autovein bypass grafts implanted into the canine femoral arteries and their distal end-to-side anastomoses was studied immunohistologically and microscopically. In the immunohistological studies, monochronal anti-collagen I,III and IV antibodies and anti-fibronectin antibody were used. 1) Studies on intimal hyperplasia of implanted autovein grafts:The luminal surface of the autovein grafts was completely covered with endothelial-like cells 7 days after implantation. The endothelial-like cells were positive for collagen I,III and IV staining and for fibronectin staining. At 2 weeks, the superficial limited 2-3 layers of the neointima of vein grafts were strongly positive for collagen I,III and IV staining and for fibronectin staining, and these findings were similar to those in the intimal layer of the artery. 2) Studies on intimal hyperplasia at distal end-to-side anastomosis:Intimal hyperplasia with development of considerable vasa vasorum was con-siderable at the toe and heel of the distal end-to-side anastomosis more than 3 months after implantation. The hyperplastic neointima at the anastomosis was diffusely positive for collagen I and III staining and for fibronectin staining. However, the staining for collagen III faintly positive in the superficial 2-3 layers. From these results, it was considered that the tissues in the neointima of the arterially implanted autovein graft have collagen fibers resembled to those in the arterial intima, however collagen fibers proliferated into the neointima at the distal end-to-side anastomosis were different from those in the neointima of the vein graft and the arterial intima.