Badylak S F, Lantz G C, Coffey A, Geddes L A
Hillenbrand Biomedical Engineering Center, School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907.
J Surg Res. 1989 Jul;47(1):74-80. doi: 10.1016/0022-4804(89)90050-4.
Autogenous saphenous vein and synthetic materials, such as Dacron and expanded polytetrafluoroethylene, have been used extensively as vascular grafts with moderate success. Improved success rates for vascular graft surgery may be possible if superior graft material was available. We tested the use of autogenous small intestinal submucosa (SIS) as a large diameter (10 mm) vascular graft in the infrarenal aorta of 12 dogs. One dog died with graft thrombosis within 48 hr of surgery. Nine dogs were sacrificed at various times during a 52-week post-surgical period and showed patent grafts without infection, thrombosis, intimal hyperplasia, or adverse effects upon blood pressure. There was no ultrastructural evidence of endothelial cell growth on the luminal surface of the SIS graft which was composed of a dense, non-thrombogenic, organized collagenous connective tissue. The SIS material was approximately one order of magnitude less elastic than natural aorta and showed an immediate dilatation of approximately 18% after exposure to the systemic blood pressure. However, there was no progressive dilatation during the 52-week postsurgical period. Two dogs remain alive at 8 and 52 weeks post-surgery with patent grafts as determined by positive contrast radiography and Doppler studies. We conclude that autogenous small intestinal submucosa can be successfully used as a large diameter arterial graft in the dog and is worthy of further investigation.
自体隐静脉和合成材料，如涤纶和膨体聚四氟乙烯，已被广泛用作血管移植物，取得了一定的成功。如果能有更好的移植物材料，血管移植手术的成功率可能会提高。我们测试了将自体小肠黏膜下层（SIS）作为大口径（10毫米）血管移植物用于12只犬的肾下腹主动脉。1只犬在手术后48小时内死于移植物血栓形成。9只犬在术后52周的不同时间被处死，结果显示移植物通畅，无感染、血栓形成、内膜增生或对血压的不良影响。在由致密、无血栓形成、有组织的胶原结缔组织构成的SIS移植物管腔表面，没有内皮细胞生长的超微结构证据。SIS材料的弹性比天然主动脉小约一个数量级，在暴露于体循环血压后立即扩张约18%。然而，在术后52周期间没有进行性扩张。通过阳性对比造影和多普勒研究确定有2只犬在术后8周和52周时存活，移植物通畅。我们得出结论，自体小肠黏膜下层可成功用作犬的大口径动脉移植物，值得进一步研究。
