A Study of Anastomotic Neointimal Hyperplasia After Graft Inplantation.

移植物植入后吻合口新内膜增生的研究。

• 批准号: 01570699
• 负责人: SAKUMA Makoto
• 金额: $ 1.02万
• 依托单位: Hokkaido University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1989
• 资助国家: 日本
• 起止时间: 1989 至 1990
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-01570699/
• 关键词: Anastomotic neointimal hyperplasia; Vascular prosthesis; Arterial reconstructive surgery; Graft obstruction; Platelet scintigraphy; anastomotic neointimal hyperplasia

Despite improvement of the vascular prostheses, the long term patency rate remains unfulfilled after small caliver graft implantation. Anastomotic neointimal hyperplasia (ANH) is known as a contributing factor of graft occlusion after implantation and the difference of mechanical properties between a vascular prosthesis and its host arteries, abnormal graft flow, intimal trauma due to surgical procedure, platelet aggregation in a surface of anastomotic site, suture material and method are suggested the factors of ANH.In this study, we investigated (1) the difference of mechanical properties between vascular grafts and host arteries. (2) small caliber(3mm in diameter) graft implantation in dogs and long term observation of the anastomotic site after implantation. (3) comparison of thrombogenecity of grafts and ANH. The results are as follows ;(1) A new type ultrasonic displacement meter was developed and compliance of arterial grafts ware measured. In comparison of compliance of human a … More rteries to that of grafts, a mismatch in compliance between grafts and arteries was obviously demonstrated.(2) In dogs, carotid artery was replaced with different compliance of graft (ePTFE, segmented polyurethane graft) 3mm in diameter and long term observation was performed. The rate of patency was good in high compliance graft (50%/1 year) but ANH was occurred both in low compliance graft and high compliant graft. Compliance mismatch between vascular prosthesis and host arteries is suggested to be one of the factor contributing ANH, but it seems to be not a main factor.(3) To evaluate relationship between platelet aggregation in a surface of graft and ANH. In^<111> platelet scintigraphy was performed in the early and late stage of graft implantation. There was significant difference of the patency rate between high platelet aggregation group and low plate let aggregation group in the early stage after implantation but there was no difference of occurrence of ANH between the two groups. Less

尽管血管假体有所改进，但小口径移植物植入后的长期通畅率仍未达到要求。吻合口新生内膜增生（ANH）被认为是移植物植入后闭塞的一个影响因素，人工血管与其宿主动脉之间的机械性能差异、移植物血流异常、手术造成的内膜损伤、吻合口表面血小板聚集、缝合材料和方法等被认为是导致ANH的因素。在本研究中，我们调查了ANH的影响因素。 (1)移植血管与宿主动脉力学性能的差异。 (2)犬小口径(直径3mm)移植物植入及植入后吻合口长期观察。 (3)移植物与ANH的血栓形成性比较。研究结果如下：(1)研制了新型超声位移计并测量了移植动脉的顺应性。在人体动脉与移植物的顺应性比较中，明显表现出移植物与动脉之间的顺应性不匹配。(2)在犬中，用直径3mm的不同顺应性的移植物(ePTFE、分段聚氨酯移植物)代替颈动脉，并进行长期观察。高顺应性移植物的通畅率良好（50%/1年），但低顺应性移植物和高顺应性移植物均发生ANH。人工血管与宿主动脉的顺应性不匹配被认为是造成ANH的因素之一，但似乎并不是主要因素。(3)评价移植物表面血小板聚集与ANH的关系。 In^<111>在移植物植入的早期和晚期进行血小板闪烁扫描。植入后早期高血小板聚集组和低血小板聚集组的通畅率有显着性差异，但两组间ANH的发生率无差异。较少的

项目成果

佐久間 まこと,他: "閉塞性動脈硬化症の治療" 現代医療. 22. 1602-1606 (1990)

Makoto Sakuma 等人：“动脉硬化闭塞症的治疗”现代医学 22. 1602-1606 (1990)。

佐久間 まこと,他: "血行再建の遠隔開存を阻止する因子とその対策ー晩期閉塞因子の解析" 脈管学. 29. 1150-1153 (1989)

Makoto Sakuma 等人：“血运重建中阻碍远程通畅的因素及其对策 - 晚期闭塞因素分析”Angiology 29. 1150-1153 (1989)。

佐久間 まこと,他: "血管吻合部内膜肥厚の発生機序と予防" 脈管学.

Makoto Sakuma 等：“血管吻合处内膜增厚的机制和预防”血管学。

Makoto Sakuma, Toshiya Nishibe, Keisyu Yasuda. and Tatsuzo Tanabe: "Mechanisms of Anastomotic Neointimal Hyperplasia" Myakkan-Gaku, The Journal of Japanese College of Angiology.

佐久间诚、西部敏也、安田启修。

佐久間 まこと,他: "新しい人工血管の開発" 脈管学.

Makoto Sakuma 等人：“新型人造血管的开发”血管学。