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

用免疫组织学和显微镜观察了移植到犬股动脉的自体静脉旁路移植物的内膜增生及其远端端侧闭塞的转归。在免疫组织学研究中，使用单时抗胶原蛋白I、III和IV抗体和抗纤连蛋白抗体。1)自体静脉移植物内膜增生的研究：移植后7天，自体静脉移植物的管腔表面完全被内皮样细胞覆盖。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，静脉移植物新生内膜的浅表有限的2-3层胶原I、III和IV染色和纤维连接蛋白染色强阳性，这些结果与动脉内膜层中的结果相似。2)远端端侧吻合处内膜增生的研究：植入后3个月以上，远端端侧吻合的趾部和足跟处内膜增生，并有大量血管形成。吻合处增生的新生内膜对胶原蛋白I和III染色以及纤连蛋白染色呈弥漫性阳性。Ⅲ型胶原染色在浅层2-3层呈弱阳性。根据这些结果，认为动脉植入的自体静脉移植物的新生内膜中的组织具有与动脉内膜中的胶原纤维相似的胶原纤维，然而，在远端端侧吻合处增殖到新生内膜中的胶原纤维与静脉移植物的新生内膜和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.