Alimi Y S, Saint Lebes B, Garitey V, Afrapoli A, Boufi M, Hartung O, Garcia S, Mouret F, Berdah S
Service de chirurgie vasculaire, Centre hospitalo-universitaire Nord, Marseille, France.
Eur J Vasc Endovasc Surg. 2009 Nov;38(5):597-602. doi: 10.1016/j.ejvs.2009.07.003. Epub 2009 Aug 5.
A feasibility study.
Eight pigs (all females; mean weight: 29 kg) underwent a conventional transperitoneal aortic approach with implantation of an aorto-prosthetic end-to-side anastomosis using a Clampless device and deployment of a 5-mm polytetrafluoroethylene (PTFE) graft. After proximal ligature, a conventional end-to-end anastomosis was then performed between the graft and the left iliac artery.
The first pig died during the procedure due to graft misplacement. The seven other procedures were successful with a mean operative and anastomosis time of 101 min (range: 81-115 min) and 3.35 min (range: 2.25-4.25 min), respectively; mean blood loss was 152 ml (range: 30-235 ml). Another pig with a patent graft died at day 4 as a result of a severe unrelated pneumonopathy. The angiogram performed during the procedure and before sacrifice, at 2 (n=2), 4 (n=2) and 6 weeks (n=2), showed no graft stenosis or thrombosis. Microscopic examination revealed a tissue covering the intraluminal stent, which evolved over time, with no visible endothelial proliferation or inflammation.
An aorto-prosthetic anastomosis can be performed safely and efficiently with our new clampless and sutureless device. The next step will be a laparoscopic Clampless implantation.
一项可行性研究。
八头猪（均为雌性；平均体重：29千克）接受了传统的经腹主动脉入路，使用无夹装置进行主动脉-人工血管端侧吻合，并植入5毫米聚四氟乙烯（PTFE）移植物。近端结扎后，在移植物与左髂动脉之间进行传统的端端吻合。
第一头猪在手术过程中因移植物放置不当死亡。其他七例手术成功，平均手术时间和吻合时间分别为101分钟（范围：81 - 115分钟）和3.35分钟（范围：2.25 - 4.25分钟）；平均失血量为152毫升（范围：30 - 235毫升）。另一头移植物通畅的猪在第4天因严重的无关肺部疾病死亡。在手术过程中以及处死前2周（n = 2）、4周（n = 2）和6周（n = 2）进行的血管造影显示，移植物无狭窄或血栓形成。显微镜检查显示腔内支架有组织覆盖，且随时间演变，未见明显的内皮细胞增殖或炎症。
使用我们新的无夹无缝合装置可以安全、有效地进行主动脉-人工血管吻合。下一步将是腹腔镜下无夹植入。
