Goëau-Brissonnière O A, Qanadli S D, Ippoliti A, Pistolese G R, Coggia M, Pollock J G
Division of Vascular Surgery and the Department of Radiology, Ambroise Paré University Hospital, Boulogne-Billancourt, France.
J Vasc Surg. 2000 Jan;31(1 Pt 1):157-63. doi: 10.1016/s0741-5214(00)70077-2.
The aim of this study was to prospectively evaluate the postoperative dilation of two types of knitted polyester arterial prostheses with the use of helical computed tomographic scanning.
Thirty-four patients who underwent aortoiliac or aortofemoral bifurcation grafting were randomized to receive a collagen-sealed warp-knitted polyester graft (n = 16 patients) or a gelatin-sealed Köper-knitted polyester graft (n = 18 patients). Alterations in size of all parts of the grafts were evaluated by helical computed tomographic scanning at postoperative day 8, at 3 months, and at 6 months.
On postoperative day 8, the mean dilation of the Köper-knitted grafts was 18% +/- 8% for the stem and 15% +/- 12% for the limbs. At the same time period, the mean dilation of warp-knitted grafts was 27% +/- 13% for the stem and 33% +/- 18% for the limbs. No increase in graft dilation was observed at 3 and 6 months. Despite the wide range of values among patients with the same graft type, at each time interval, the Köper-knitted grafts dilated significantly less than the warp-knitted grafts (P <. 05).
In this randomized study, helical computed tomographic scanning was an accurate technique with which to assess graft dilation. For a 6-month follow-up interval, the Köper-knitted polyester structure dilated less than the warp-knitted structure. Longer-term serial scans should allow a better understanding of the clinical significance of graft dilation.
本研究的目的是通过螺旋计算机断层扫描前瞻性评估两种针织聚酯动脉移植物的术后扩张情况。
34例行主-髂动脉或主-股动脉分叉移植术的患者被随机分为两组,分别接受胶原密封的经编聚酯移植物(16例患者)或明胶密封的科珀针织聚酯移植物(18例患者)。在术后第8天、3个月和6个月时,通过螺旋计算机断层扫描评估移植物各部分尺寸的变化。
术后第8天,科珀针织移植物主干的平均扩张率为18%±8%,分支的平均扩张率为15%±12%。在同一时期,经编移植物主干的平均扩张率为27%±13%,分支的平均扩张率为33%±18%。在3个月和6个月时未观察到移植物扩张增加。尽管同一移植物类型的患者之间数值范围较宽,但在每个时间间隔,科珀针织移植物的扩张明显小于经编移植物(P<.05)。
在这项随机研究中,螺旋计算机断层扫描是评估移植物扩张的一种准确技术。在6个月的随访期内,科珀针织聚酯结构的扩张小于经编结构。长期的系列扫描应能更好地理解移植物扩张的临床意义。