Ratto G B, Frascio M, Secco G B, Canepa G, Fardelli R
Cattedra di Semeiotica Chirurgica I, Università di Genova.
Minerva Chir. 1990 Jan;45(1-2):37-40.
The development of reconstructive venous surgery has been hampered by the lack of suitable graft materials. Fourteen carbon fibre grafts (phi: 8 mm), 30 glutaraldehyde treated ovine collagen grafts and 29 polytetrafluoroethylene (PTFE) grafts were used to replace a 35 mm segment of infrarenal inferior vena cava in pigs. Prostheses were removed 1 hour and 7, 14, 28, 56 and 112 days after implantation. All specimens were examined by light and scanning electron microscopy. The 112 day patency rate was 67% for ovine collagen grafts, while all carbon and PTFE grafts thrombosed. The difference was statistically significant (p less than 0.01). During the first hour after implantation, a thick (800-900 microns) thrombotic layer deposited on the inner surface of carbon grafts. This layer possibly caused the subsequent complete occlusion of the tubular segments. A thin neointima (less than 200 microns) developed on the flow surface of ovine collagen prostheses. This favoured complete endothelialization of the graft inner surface as soon as four weeks after surgery. In conclusion, glutaraldehyde treated ovine collagen would represent the first sound material to be used as venous substitute.
合适的移植材料的缺乏阻碍了重建性静脉外科手术的发展。使用14根碳纤维移植物（直径8毫米）、30根经戊二醛处理的羊胶原蛋白移植物和29根聚四氟乙烯（PTFE）移植物来替代猪肾下下腔静脉的一段35毫米长的血管。在植入后1小时以及7天、14天、28天、56天和112天取出假体。所有标本均通过光学显微镜和扫描电子显微镜检查。羊胶原蛋白移植物的112天通畅率为67%，而所有碳纤维和PTFE移植物均发生血栓形成。差异具有统计学意义（p<0.01）。在植入后的第一个小时内，一层厚厚的（800-900微米）血栓层沉积在碳纤维移植物的内表面。这一层可能导致了随后管状节段的完全闭塞。在羊胶原蛋白假体的血流表面形成了一层薄的新生内膜（小于200微米）。这有利于在手术后四周内移植物内表面完全内皮化。总之，经戊二醛处理的羊胶原蛋白将是第一种可作为静脉替代物的优质材料。
