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

对犬自体静脉旁路移植于犬股动脉及其远端端侧吻合段内膜增生的转归进行了免疫组织学和光镜观察。在免疫组织学研究中，使用了单抗I型、III型和IV型胶原抗体和抗纤维连接蛋白抗体。1)移植自体静脉内膜增生情况的研究：移植后7d，移植静脉的管腔表面已完全被内皮样细胞覆盖。内皮样细胞I型、III型、IV型胶原染色阳性，纤维连接蛋白染色阳性。移植静脉移植后2周，浅层有限的2~3层新生内膜I、III、IV型胶原和纤维连接蛋白染色呈强阳性，与动脉内膜层相似。2)端侧吻合口远端内膜增生情况的研究：端侧吻合术后3个月以上，远端吻合的足趾、足跟处可见内膜增生，并可见大量血管形成。吻合口增生性新生内膜I、III型胶原和纤维连接蛋白染色呈弥漫性阳性。III型胶原在浅层2~3层呈弱阳性反应。结果表明，动脉移植的自体静脉移植物的新生内膜组织中含有与动脉内膜相似的胶原纤维，而端侧吻合远端处的胶原纤维增殖到新生内膜与移植静脉的新生内膜及动脉内膜中的胶原纤维不同。

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.