Sawyer P N
Downstate Medical Center, Brooklyn, New York.
J Appl Biomater. 1990 Summer;1(2):143-51. doi: 10.1002/jab.770010207.
Since modern vascular surgery started with the discovery of heparin and the development of modern vascular grafts including autogenous saphenous vein, the speciality has been technologically driven. At the outset, vascular surgery depended almost entirely on the development of specialized clamps, instruments, and tools to permit decisive attack on the problems of occlusion. No less important was the development of insight into the basis of atherosclerosis, the discovery that atherogenesis with thrombosis is electrochemically identical to corrosion in pipes and therefore subject to chemical forces, which have not yet been delineated, as well as mechanical forces which have been delineated and permit one to attack the atheroma directly. Thus, classic replumbing techniques including bypass and endarterectomy have long been a part of the fundamental firmament of vascular surgery. Most recently, modern techniques in cleaning out blood vessels, removing occlusive processes, and modern thrombus-dissolving enzymes have all come to the forefront. Frequently multiple techniques are used simultaneously. This article is an attempt to summarize various aspects of this activity and describe several of the patents which have been seminal in the ultimate application of the techniques in both experimental animals and man. This should be the first of a series of efforts to summarize this area. The process of change has never been more kinetic than now.
自从现代血管外科随着肝素的发现以及包括自体大隐静脉在内的现代血管移植物的发展而起步以来，该专业一直由技术驱动。一开始，血管外科几乎完全依赖于专门夹具、器械和工具的发展，以便对闭塞问题发起决定性的攻击。对动脉粥样硬化基础的深入理解同样重要，即发现伴有血栓形成的动脉粥样硬化在电化学上与管道腐蚀相同，因此会受到尚未明确的化学力以及已明确的机械力的影响，而机械力使人们能够直接攻击动脉粥样硬化斑块。因此，包括旁路手术和动脉内膜切除术在内的经典血管重建技术长期以来一直是血管外科基础框架的一部分。最近，清理血管、消除闭塞过程的现代技术以及现代溶栓酶都已成为前沿技术。通常会同时使用多种技术。本文旨在总结这一领域的各个方面，并描述一些在实验动物和人类中最终应用这些技术方面具有开创性的专利。这应该是总结该领域的一系列努力中的第一篇。变革的进程从未像现在这样活跃。
