van der Lei B, Bartels H L, Dijk F, Schakenraad J M, Nieuwenhuis P, Robinson P H
Department of Surgery, University Hospital, Groningen, The Netherlands.
Microsurgery. 1991;12(1):23-9. doi: 10.1002/micr.1920120106.
Polytetrafluoroethylene (PTFE) prostheses (Gore-Tex; ID, 1 mm; length, 5-7 mm; wall thickness, 0.2 mm; fibril length, 30 microns, n = 28) were implanted into the rat femoral vein by means of the sleeve anastomotic technique to enhance the patency rate. In the control group, PTFE prostheses (n = 8) were implanted by means of the end-to-end technique. In the experimental group patency and healing of the PTFE prostheses were evaluated at 1 day (n = 4), 1 week (n = 6), 3 weeks (n = 6), 6 weeks (n = 6), and 12 weeks (n = 6) after implantation by means of macroscopic inspection and routine light and scanning electron microscopy. All prostheses, except one at 1 week after implantation, were patent at the time of removal. All of the microvenous prostheses were completely covered by an endothelial layer at 3, 6, and 12 weeks after implantation. Occasionally some smooth muscle-like cells could be found underneath this endothelial layer, but stenosis was never observed at the anastomotic sites. Only scarce tissue ingrowth was observed in the wall of the PTFE prostheses. In the control group, all prostheses, except one prosthesis after 3 weeks, were found to be occluded. An occlusive mural thrombus was found firmly attached at the anastomoses at 1 day, and an organized thrombus at 3 weeks after implantation. The patent prosthesis demonstrated complete endothelial healing. These results demonstrate the importance of the sleeve anastomotic technique and the potential of PTFE prostheses as a microvenous conduit when implanted by means of the sleeve anastomotic technique in experimental reconstructive microvascular procedures.
采用套入式吻合技术将聚四氟乙烯（PTFE）假体（戈尔特斯；内径1毫米；长度5 - 7毫米；壁厚0.2毫米；纤维长度30微米，n = 28）植入大鼠股静脉，以提高通畅率。对照组采用端端吻合技术植入PTFE假体（n = 8）。在实验组，于植入后1天（n = 4）、1周（n = 6）、3周（n = 6）、6周（n = 6）和12周（n = 6），通过大体检查、常规光学显微镜和扫描电子显微镜评估PTFE假体的通畅情况和愈合情况。除植入后1周有1个假体不通畅外，所有假体在取出时均通畅。所有微静脉假体在植入后3周、6周和12周时均完全被内皮细胞层覆盖。偶尔在该内皮细胞层下方可发现一些平滑肌样细胞，但在吻合部位从未观察到狭窄。在PTFE假体壁内仅观察到少量组织长入。在对照组中，除3周后有1个假体通畅外，其余所有假体均闭塞。在植入后1天，发现闭塞性壁血栓牢固附着于吻合口处，在植入后3周发现机化血栓。通畅的假体显示出完全的内皮愈合。这些结果证明了套入式吻合技术的重要性，以及在实验性微血管重建手术中采用套入式吻合技术植入时，PTFE假体作为微静脉导管的潜力。
