Kidson I G, Abbott W M
Vascular Research Laboratory, Department of Surgery, Harvard Medical School, The Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Circulation. 1978 Sep;58(3 Pt 2):I1-4.
Early closure of arterial grafts is not fully understood. Patency loss in saphenous vein at 1 year is 12 to 30%. Synthetic grafts are worse. Stiff grafts may impede pulsatile flow and interfere with energy propagation. In vivo compliance (C, % radial change/mm Hg x 10(2) +/- SEM), derived from pressure and diameter measurements, was assessed in 38 arteries and 60 arterial grafts in a standardized canine femoral artery bypass model. Normal artery (C = 7.40 +/- 0.73) was more compliant than any graft (P < 0.01). At implantation, vein (C = 2.67 +/- 0.18) was more compliant than double velour Dacron (C = 1.86 +/- 0.16) or expanded polytetrafluoroethylene (C = 1.63 +/- 0.14) (P < 0.01). Vein graft patency at 2 weeks was 83%, Dacron 64% (P = 0.13), and PTFE 32% (P < 0.01). Vein compliance did not change with implantation. Vein patency was maintained, but Dacron fell to 29% and PTFE to 14% by 3 months. A definite correlation was shown between patency and compliance. It is suggested that more attention should be devoted to elastic properties in the design of arterial grafts.
动脉移植物的早期闭塞机制尚未完全明确。隐静脉移植物1年时的通畅率损失为12%至30%。人工合成移植物的情况更糟。僵硬的移植物可能会阻碍搏动性血流并干扰能量传播。在标准化犬股动脉旁路模型中，对38条动脉和60个动脉移植物进行了评估，通过压力和直径测量得出体内顺应性（C，%径向变化/毫米汞柱×10(2)±标准误）。正常动脉（C = 7.40±0.73）的顺应性高于任何移植物（P < 0.01）。植入时，静脉（C = 2.67±0.18）的顺应性高于双层丝绒涤纶（C = 1.86±0.16）或膨体聚四氟乙烯（C = 1.63±0.14）（P < 0.01）。2周时静脉移植物通畅率为83%，涤纶为64%（P = 0.13），聚四氟乙烯为32%（P < 0.01）。静脉的顺应性不会因植入而改变。静脉通畅率得以维持，但到3个月时，涤纶降至29%，聚四氟乙烯降至14%。通畅率与顺应性之间存在明确的相关性。建议在动脉移植物设计中应更多关注弹性特性。
