血管内动脉瘤修复术后移植物压力传导导致的内张力——一项体外研究

Endotension as a result of pressure transmission through the graft following endovascular aneurysm repair--an in vitro study.

作者信息

Gawenda M, Jaschke G, Winter St, Wassmer G, Brunkwall J

机构信息

Division of Vascular Surgery, Department of Surgery, Medical Center, University of Cologne, Germany.

出版信息

Eur J Vasc Endovasc Surg. 2003 Nov;26(5):501-5. doi: 10.1016/s1078-5884(03)00378-2.

DOI:10.1016/s1078-5884(03)00378-2

PMID:14532877

Abstract

BACKGROUND

endovascular aneurysm repair (EVAR) significantly reduces, but does not abolish aneurysm sac pressure, possibly because of trans-fabric transmission.

OBJECTIVE

to investigate how blood pressure is transmitted through different types of grafts into the aneurysm sac.

DESIGN

experimental study, in vitro.

METHODS

a latex aneurysm was inserted into an in vitro circulation model. The systemic mean pressure (SPmean) was varied from 50 to 120 mmHg. The grafts used for aneurysm exclusion were: thin wall polyethylene (PE), thick wall polyethylene (PE) and thin wall ePTFE. Mean aneurysm sac pressure (ASPmean) was measured, as was pulse pressure (ASPpulse).

RESULTS

at an SPmean of 70 mmHg, the ASPmean was 34 +/- 0.8 mmHg (polyethylene knitted, thick wall), 30 +/- 1.0 mmHg (polyethylene woven, thin wall), and 17 +/- 0.6 mmHg (thin wall ePTFE). The ASPmean increased with SPmean, the relationship depending on the graft material. Stiffer grafts were associated with lower ASPmean and ASPpulse (p<0.001).

CONCLUSIONS

the relationship between aneurysm sac mean pressure and systemic pressure (SP) depends on the graft material. These data highlights the need for further studies regarding endotension.

摘要

背景

血管内动脉瘤修复术（EVAR）可显著降低但不能消除动脉瘤囊内压力，可能是由于通过人工血管的压力传导。

目的

研究血压如何通过不同类型的移植物传导至动脉瘤囊内。

设计

体外实验研究。

方法

将一个乳胶动脉瘤置入体外循环模型。全身平均压力（SPmean）在50至120 mmHg之间变化。用于排除动脉瘤的移植物有：薄壁聚乙烯（PE）、厚壁聚乙烯（PE）和薄壁ePTFE。测量动脉瘤囊平均压力（ASPmean）和脉压（ASPpulse）。

结果

在SPmean为70 mmHg时，ASPmean分别为34±0.8 mmHg（厚壁聚乙烯编织物）、30±1.0 mmHg（薄壁聚乙烯编织物）和17±0.6 mmHg（薄壁ePTFE）。ASPmean随SPmean升高，其关系取决于移植物材料。更硬的移植物与更低的ASPmean和ASPpulse相关（p<0.001）。