Uchida N, Emoto H, Kambic H, Harasaki H, Chen J F, Hsu S H, Murabayashi S, Nosé Y
Department of Artificial Organs, Cleveland Clinic Foundation, OH 44195-5132.
ASAIO Trans. 1989 Jul-Sep;35(3):556-8. doi: 10.1097/00002480-198907000-00124.
The compliance mismatch hypothesis as a cause of failure of small diameter grafts was investigated using 4 mm internal diameter, 5 cm long Biolized polyurethane grafts. The luminal surface of 0.5 mm thick Biomer sponge grafts was covered with 100 microns of crosslinked gelatin. Compliance matched, and noncompliant grafts had in vivo compliance values of 13.5 +/- 2.89 and 1.0 +/- 0.7 X 10(-2%) per mmHg, respectively. In vivo compliance defined as 2 X dD/dP X 1/Do was measured in situ using the ultrasonic Hokanson probe. Compliance values of compliant grafts equaled that of the canine carotid artery at 100 mmHg mean arterial pressure. Grafts were implanted using an end-to-end anastomosis in 14 dogs for 6 wk. Patency rates for compliant vs. noncompliant grafts were 64% (9/14) and 50% (7/14). Compliance values for compliant grafts decreased to a mean of 7.14 X 10(-2%) per mmHg. Anastomotic intimal hyperplasia at the proximal and distal ends of compliant and noncompliant grafts measured 239.9 +/- 128, 197 +/- 129 microns, 338.9 +/- 273.6, and 304.3 +/- 179.3 microns, respectively. There were no significant differences in localized anastomotic intimal hyperplasia at either graft end for either graft type. This study did not show any positive effects of graft compliance.
使用内径4mm、长度5cm的生物活性聚氨酯移植物，研究了顺应性不匹配假说作为小直径移植物失败原因的情况。0.5mm厚的生物材料海绵移植物的管腔表面覆盖有100微米的交联明胶。顺应性匹配的和非顺应性的移植物的体内顺应性值分别为每毫米汞柱13.5±2.89和1.0±0.7×10⁻²%。使用超声霍坎森探头原位测量定义为2×dD/dP×1/Do的体内顺应性。顺应性移植物在平均动脉压100mmHg时的顺应性值与犬颈动脉的顺应性值相等。在14只狗中使用端端吻合术植入移植物6周。顺应性移植物与非顺应性移植物的通畅率分别为64%（9/14）和50%（7/14）。顺应性移植物的顺应性值降至平均每毫米汞柱7.14×10⁻²%。顺应性和非顺应性移植物近端和远端的吻合口内膜增生分别为239.9±128、197±129微米、338.9±273.6和304.3±179.3微米。两种移植物类型在任何一种移植物末端的局部吻合口内膜增生均无显著差异。本研究未显示移植物顺应性有任何积极作用。
