Sato S, Niu S, Kanda K, Oka T, Wildevuur C R
Second Surgical Department, Kyoto Prefectural University of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1992 Apr;93(4):419-28.
Autologous vein graft is frequently used for arterial reconstruction in vascular surgery. Its' long-term patency rate, however, is low because of the degenerative changes of the vein wall. Of the basis of our hypothesis that the degenerative changes are mainly caused by an over-distension of vein wall in arterial system, in this study, autologous vein grafts of rabbit (N = 56) were implanted in the carotid arteries. To prevent overdistension, some of the grafts were covered with prosthesis which was made of microporous, compliant biodegradable polyurethane and were compared with those without prosthesis. The integrity of the architecture of the vein wall covered with prosthesis was well preserved at 6 weeks after implantation, where the biodegradation of prosthesis induced an optimal arterialization of the vein grafts. The results indicate that this method may prevent the degenerative changes of vein wall such as fibrosis and intimal hyperplasia, which would cause poor long-term patency of vein graft used for arterial reconstruction.
自体静脉移植物在血管外科手术中常用于动脉重建。然而,由于静脉壁的退行性改变,其长期通畅率较低。基于我们的假设,即退行性改变主要是由静脉壁在动脉系统中的过度扩张引起的,在本研究中,将兔自体静脉移植物(N = 56)植入颈动脉。为防止过度扩张,一些移植物用由微孔、顺应性可生物降解聚氨酯制成的假体覆盖,并与未使用假体的移植物进行比较。植入后6周,覆盖假体的静脉壁结构完整性得到良好保存,此时假体的生物降解诱导了静脉移植物的最佳动脉化。结果表明,这种方法可能预防静脉壁的退行性改变,如纤维化和内膜增生,而这些改变会导致用于动脉重建的静脉移植物长期通畅性不佳。