Moritz A, Magometschnigg H, Ptakovsky H, Windberger U, Raderer F, Grabenwöger F, Wolner E
2nd Department of Surgery, University of Wien, Austria.
Int J Artif Organs. 1991 Jul;14(7):435-40.
To avoid non-autogenous vascular prostheses in coronary and peripheral vascular procedures, otherwise unusable dilated, varicose or thin-walled veins can be implanted as naturally endothelialized grafts after being calibrated by insertion into mesh tubes. In six sheep the 14 mm diameter jugular vein was inserted into a 12 cm long, 6 mm diameter Dacron mesh tube and implanted as a femoropopliteal graft. On the contralateral side the femoral vein with a maximal diameter of 7 to 8 mm was implanted. At control angiography after two months all grafts were patent, none of the wrapped grafts showed wrinkles or signs of anastomotic hyperplasia. Segments of wrapped veins were casted in paraffin under physiological pressure and cut transversely. In all cases the vein wall was pressed against the mesh tubes without forming folds. Mesh-wrapped varicose veins were used for three femorocrural and seven femoropopliteal reconstructions. All grafts showed a smooth flow surface at control angiography. Indentations occurred only at sites where thick-walled side branches had been ligated rather than oversewn. One popliteo-pedal reconstruction occluded after two months and one patient with a crural reconstruction died two months after surgery with a patent graft. The remaining grafts were patent after 11 (2-32) months. Oversized veins can be considerably constricted by tubes without forming wrinkles. By this technique varicose veins can be used as bypass grafts and in general vein grafts can be matched in size to the recipient vessel.
为避免在冠状动脉和外周血管手术中使用非自体血管假体，原本无法使用的扩张、曲张或薄壁静脉可在插入网管进行校准后，作为自然内皮化移植物植入。在六只绵羊中，将直径14毫米的颈静脉插入一根12厘米长、直径6毫米的涤纶网管中，并作为股腘动脉移植物植入。在对侧植入最大直径为7至8毫米的股静脉。两个月后的对照血管造影显示所有移植物均通畅，所有包裹的移植物均未出现皱纹或吻合口增生迹象。将包裹静脉的节段在生理压力下石蜡包埋并横向切片。在所有病例中，静脉壁均紧贴网管，未形成褶皱。网状包裹的曲张静脉用于3例股胫动脉和7例股腘动脉重建。在对照血管造影中，所有移植物均显示血流表面光滑。仅在结扎而非缝合厚壁侧支的部位出现压痕。1例腘动脉-足背动脉重建术后两个月闭塞，1例胫动脉重建患者术后两个月死亡，移植物通畅。其余移植物在11（2-32）个月后仍通畅。超大的静脉可被管子显著收缩而不形成皱纹。通过这种技术，曲张静脉可作为旁路移植物使用，一般来说静脉移植物的大小可与受体血管匹配。
