Stojanovic Tomislav, El-Sayed Ahmad Ali, Didilis Vasilios, Ali Osama, Popov Aron F, Danner Bernd C, Seipelt Ralf, Dörge Hilmar, Schöndube Friedrich A
Department of Cardiothoracic and Vascular Surgery, Universitätsmedizin Göttingen, Göttingen, Germany.
Langenbecks Arch Surg. 2009 Mar;394(2):357-62. doi: 10.1007/s00423-008-0341-3. Epub 2008 May 29.
External support of vein grafts by fibrin glue possibly prevents overdistension, vascular remodeling, and neointimal hyperplasia. Previous animal models of neointimal hyperplasia showed conflicting results. Here, long-term effects of external fibrin glue support were studied in a new rat model of jugular vein to abdominal aorta transposition. MATERIALS AND METHODS AND METHODS: In male Wistar rats (250-300 g) right jugular vein (1.0-1.5 cm) was transposed to the infrarenal aorta. Fibrin glue (0.25 ml) covered the vein before releasing the vascular clamps (n = 6). Control vein grafts were exposed directly to blood pressure. After 16 weeks vein grafts were pressure-fixed for histology. Intima thickness, luminal and intimal area were measured by planimetry and elastic fibers demonstrated by Elastica van Giesson staining.
Intimal thickness (74.04 +/- 6.7 microm vs 1245 +/- 187 microm, control vs fibrin treatment; p < 0.001), intimal area (2517.16 +/- 355 mm(2) vs 18424 +/- 4927 mm(2), control vs fibrin treatment; p < 0.05) and luminal area (2184.75 +/- 347 mm(2) vs 7231.85 +/- 1782 mm(2), control vs fibrin treatment; p < 0.05) were significantly increased, elastic fibers in the vessel wall were diminished and the vessel wall infiltrated by mononuclear cells in fibrin glue supported veins.
External support of vein grafts by fibrin glue leads to aneurysmal degeneration and intimal hyperplasia, thereby possibly jeopardizing long-term graft patency.
纤维蛋白胶对静脉移植物的外部支撑可能预防过度扩张、血管重塑和内膜增生。以往内膜增生的动物模型结果相互矛盾。在此，我们在一种新的大鼠颈静脉至腹主动脉转位模型中研究了纤维蛋白胶外部支撑的长期效果。
在雄性Wistar大鼠（250 - 300克）中，将右侧颈静脉（1.0 - 1.5厘米）转位至肾下腹主动脉。在松开血管夹之前，用纤维蛋白胶（0.25毫升）覆盖静脉（n = 6）。对照静脉移植物直接暴露于血压。16周后，对静脉移植物进行压力固定以进行组织学检查。通过平面测量法测量内膜厚度、管腔和内膜面积，并用弹性纤维染色法显示弹性纤维。
内膜厚度（对照组与纤维蛋白治疗组分别为74.04±6.7微米 vs 1245±187微米；p < 0.001）、内膜面积（对照组与纤维蛋白治疗组分别为2517.16±355平方毫米 vs 18424±4927平方毫米；p < 0.05）和管腔面积（对照组与纤维蛋白治疗组分别为2184.75±347平方毫米 vs 7231.85±1782平方毫米；p < 0.05）均显著增加，在纤维蛋白胶支撑的静脉中，血管壁中的弹性纤维减少，血管壁被单核细胞浸润。
纤维蛋白胶对静脉移植物的外部支撑导致动脉瘤样变性和内膜增生，从而可能危及移植物的长期通畅。
