Malchesky P S, Koshino I, Pennza P, Kirlay R, Nosé Y
Trans Am Soc Artif Intern Organs. 1975;21:310-9.
During in vivo sheep studies on biolized shunts of a unique geometry it was found that venous stenosis was produced in 3 of 3 implants, suggesting its use as a model for the study of this lesion. Hemodynamic data on biolized shunts of different geometry and silicone shunts did not demonstrate significant differences among them. In general, venous side pressures were low and steady. Arterial side pressures upon stabilization were not significantly different than the controls. Time averaged hemodunamic parameters do not appear as dominant differences between the blood access devices evaluated. Angiographic studies indicated that a divergence of flow takes place at the shunt's exist and reveled angulation between the short shunt and the vein. Venous wall immobilization at increased pressures was observed. The tension which causes the wall to be immobilized is beleived to be due to anatomical mismatch between the short shunt and the vascular connection points. Although mechanical stress to the wall, fluid dynamic events and the resultant mass transport processes all may be important in causing the development of the stenotic lesion, the data to date seem to strongly implicate mechanical factors, specifically angualtion and stretching of the vein, in the development of venous stenosis. Local fluid dynamic and mass transfer effects may aggravate the already overstressed vessel.
在对具有独特几何形状的生物化分流器进行的体内绵羊研究中发现，3个植入物中有3个出现了静脉狭窄，这表明可将其用作研究该病变的模型。不同几何形状的生物化分流器和硅胶分流器的血流动力学数据显示它们之间没有显著差异。一般来说，静脉侧压力较低且稳定。稳定后的动脉侧压力与对照组相比无显著差异。在所评估的血液通路装置之间，时间平均血流动力学参数似乎没有明显差异。血管造影研究表明，分流器出口处出现血流分流，且短分流器与静脉之间存在成角现象。观察到在压力升高时静脉壁固定。据信导致静脉壁固定的张力是由于短分流器与血管连接点之间的解剖学不匹配所致。尽管对静脉壁的机械应力、流体动力学事件以及由此产生的物质传输过程在导致狭窄病变的发展中都可能很重要，但迄今为止的数据似乎强烈表明机械因素，特别是静脉的成角和拉伸，在静脉狭窄的发展中起作用。局部流体动力学和物质转移效应可能会使本已承受过度压力的血管情况恶化。
