Stewart G J, Essa N, Chang K H, Reichle F A
J Lab Clin Med. 1975 Feb;85(2):208-26.
The sequence of events occurring in a woven Dacron bypass in the canine thoracic aorta was followed from the first exposure to flowing blood for a period of 27 months. After 10 and 40 minutes exposure to flowing blood the surface was covered with masses of leukocytes, platelets, red cells, and some fibrin. By 24 and 48 hours most of the leukocytes had disappeared leaving the two end areas of the bypass covered with a thick film composed of red cells entrapped in a fibrin net. In the central portion of the bypass the Dacron fibers were covered by a rough film of particulate material and widely spaced clumps of platelets and occasional leukocytes connected by a few fibrin strands. AT 6 AND 7 DAYS THE SURFACE COVERING CONSISTED PRIMARILY OF RED CELLS AND FIBRIN. Between 2 and 8 weeks this was replaced by a matrix that was composed mostly of cells resembling fibroblasts or transition forms between these and smooth muscle cells. Some typical smooth muscle cells were observed in grafts 4 months or older. A sheet of flat cells had grown a few millimeters below the anastomoses at 7, 12, and 14 months. By 27 months the entire length of the graft had a patchy covering of endothelium. Only occasional isolated platelets were stuck to the exposed collagen. Thickening of the intraprosthetic lining was associated with infiltration of the cell-fiber matrix by masses of red cells. Thus it appears that under proper conditions of flow, thrombogenic surfaces such as Dacron and collagen are "conditioned" to become nonthrombogenic by the limited deposition of blood elements.
对犬胸主动脉中编织涤纶旁路血管内从首次接触流动血液起27个月内发生的一系列事件进行了跟踪观察。在接触流动血液10分钟和40分钟后，其表面覆盖着大量白细胞、血小板、红细胞及一些纤维蛋白。到24小时和48小时时，大多数白细胞消失，旁路血管的两个端部区域覆盖着一层由被困在纤维蛋白网中的红细胞组成的厚膜。在旁路血管的中央部分，涤纶纤维被一层粗糙的颗粒物质膜覆盖，还有间隔很宽的血小板团块以及偶尔出现的由几条纤维蛋白丝相连的白细胞。在6天和7天时，表面覆盖物主要由红细胞和纤维蛋白组成。在2至8周之间，这被一种基质所取代，该基质主要由类似于成纤维细胞的细胞或这些细胞与平滑肌细胞之间的过渡形式的细胞组成。在4个月或更久的移植物中观察到了一些典型的平滑肌细胞。在7个月、12个月和14个月时，在吻合口下方几毫米处有一层扁平细胞生长。到27个月时，移植物的整个长度都有不连续的内皮覆盖。只有偶尔有单个血小板黏附在暴露的胶原上。人工血管内衬增厚与大量红细胞浸润细胞 - 纤维基质有关。因此，在适当的血流条件下，诸如涤纶和胶原等促血栓形成表面似乎会通过血液成分的有限沉积而被“驯化”，从而变得不具有血栓形成性。
