Greisler H P, Dennis J W, Endean E D, Ellinger J, Buttle K F, Kim D U
Department of Surgery, Loyola University School of Medicine, Maywood, Illinois.
Circulation. 1988 Sep;78(3 Pt 2):I6-12.
Vascular prostheses woven from absorbable lactide/glycolide copolymers are replaced by myofibroblast-laden tissue conduits lined by endothelium. When these prostheses are implanted in arteries of animal models, the absorption-replacement reactions are inhibited by Dacron. To determine whether these reactions resulted primarily from transanastomotic pannus ingrowth, prostheses (30 mm x 4 mm) were constructed of three 10-mm long segments with Dacron segments on both ends and a middle polyglactin 910 (PG910) segment. The prostheses were implanted in the aortas of 15 adult New Zealand White rabbits. Resultant prosthesis/tissue complexes were harvested in triplicate at 2 weeks and at 1, 2, 3, and 4 months after implantation. Explants were photographed and sectioned for light microscopy and for scanning and transmission electron microscopy, which showed 100% patency with no aneurysms or stenoses. Inner-capsule thickness in the PG910 segments increased only during the interval from 2 weeks to 2 months; this thickness was statistically greater than either Dacron segment at 1 and 2 months (p less than or equal to 0.004 and p less than or equal to 0.0001, respectively). Proximal and distal Dacron segments did not differ from each other in thickness. Inner capsules of PG910 segments at 1 month were composed predominantly of myofibroblasts, whereas inner capsules of Dacron segments were composed of fibrin coagulum beyond the initial 2 mm of endothelial pannus ingrowth. These data suggest that transanastomotic pannus ingrowth is not the primary source of cells replacing absorbable vascular prostheses.
由可吸收的丙交酯/乙交酯共聚物编织而成的血管假体被内衬内皮细胞的富含肌成纤维细胞的组织导管所取代。当将这些假体植入动物模型的动脉中时，涤纶会抑制吸收 - 置换反应。为了确定这些反应是否主要源于经吻合口的血管翳向内生长，构建了长度为30毫米×4毫米的假体，该假体由两端的涤纶段和中间的聚乙醇酸910（PG910）段组成，每段长10毫米。将这些假体植入15只成年新西兰白兔的主动脉中。在植入后2周以及1、2、3和4个月，分三次采集所得的假体/组织复合物。对取出的样本进行拍照并切片，用于光学显微镜检查以及扫描和透射电子显微镜检查，结果显示通畅率为100%，无动脉瘤或狭窄。PG910段的内膜厚度仅在2周龄至2月龄期间增加；在1个月和2个月时，该厚度在统计学上显著大于涤纶段（分别为p≤0.004和p≤0.0001）。近端和远端的涤纶段厚度彼此无差异。1个月时PG910段的内膜主要由肌成纤维细胞组成，而涤纶段的内膜在最初2毫米的内皮血管翳向内生长范围之外由纤维蛋白凝块组成。这些数据表明，经吻合口的血管翳向内生长不是替代可吸收血管假体的细胞的主要来源。
