Sottiurai V S, Sue S L, Feinberg E L, Bringaze W L, Tran A T, Batson R C
Department of Surgery, Louisiana State University School of Medicine, New Orleans 70112.
Eur J Vasc Surg. 1988 Aug;2(4):245-56. doi: 10.1016/s0950-821x(88)80034-3.
Anastomotic intimal hyperplasia occurred exclusively at the heel and the toe plus the floor of the distal end-to-side anastomosis of canine autologous femoro-femoral bypass (n = 14) and not in the end-to-end carotid or femoral interposition graft (n = 14). The occurrence of anastomotic intimal hyperplasia in the absence of compliance mismatch in an autologous bypass suggests that the geometry of the end-to-side anastomosis is primarily responsible for intimal hyperplasia formation. It is believed that because an end-to-side distal anastomosis is not a natural occurrence it is conductive to turbulent flow. The latter causes endothelial injury which in turn allows platelet growth factor to incite subendothelial myoblasts in extracellular matrix synthesis and intimal hyperplasia formation. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) identify myofibroblasts and fibrocollagenous matrix as the dominant cellular and extracellular substances in anastomotic intimal hyperplasia.
在犬自体股-股旁路移植术（n = 14）中，吻合口内膜增生仅发生在足跟、趾部以及远端端侧吻合口的底部，而在颈动脉或股动脉端端植入移植物（n = 14）中未出现。在自体旁路移植中，在不存在顺应性不匹配的情况下发生吻合口内膜增生，这表明端侧吻合的几何形状是内膜增生形成的主要原因。据信，由于远端端侧吻合并非自然发生，所以会导致湍流。后者会引起内皮损伤，进而使血小板生长因子刺激细胞外基质合成中的内皮下成肌细胞并形成内膜增生。扫描电子显微镜（SEM）和透射电子显微镜（TEM）确定肌成纤维细胞和纤维胶原基质是吻合口内膜增生中主要的细胞和细胞外物质。
