Barra J A, Volant A, Leroy J P, Braesco J, Airiau J, Boschat J, Blanc J J, Penther P
J Thorac Cardiovasc Surg. 1986 Sep;92(3 Pt 1):330-6.
Saphenous veins undergo dramatic morphologic changes when used as coronary bypass grafts, and careful preparation of the graft alone is inadequate in preventing these changes. In this study, the use of a constrictive mesh for vein graft was evaluated. Fourteen sheep were subjected to a 5 cm resection of the carotid artery. Six sheep (Group A) received a jugular vein interposition graft, and the other eight sheep (Group B) received a jugular vein graft on which the constrictive mesh had been applied. The diameter of grafts in Group A was 14 +/- 1 mm compared with 7 +/- 0.5 mm for Group B (p = 0.05). The animals were put to death 4 months later. Scanning electron microscopy showed a disruption of the endothelial lining in Group A and a normal endothelium in Group B. Microscopy showed a statistical difference between Groups A and B regarding regularity and thickness of the intimal hyperplasia. Group B showed a moderate and regular intimal thickening and increased vasa vasorum. This indicates that distention and subsequent damage of the vein graft may be minimized by use of a constrictive mesh. Saphenous grafts surrounded by this constrictive mesh were inserted in four patients. Vein diameters were, respectively, 5, 4.3, 3.5, and 3.5 mm before meshing. After insertion in the mesh, vein diameters were 4.3, 3.5, 2.8, and 2.5 mm, respectively. Angiography performed 2 months later showed patent grafts of regular caliber.
大隐静脉用作冠状动脉搭桥移植物时会发生显著的形态学变化，仅对移植物进行仔细制备不足以预防这些变化。在本研究中，评估了使用收缩网对静脉移植物的作用。14只绵羊接受了5厘米的颈动脉切除术。6只绵羊（A组）接受颈静脉间置移植物，另外8只绵羊（B组）接受应用了收缩网的颈静脉移植物。A组移植物直径为14±1毫米，而B组为7±0.5毫米（p = 0.05）。4个月后将动物处死。扫描电子显微镜显示A组内皮衬里破坏，B组内皮正常。显微镜检查显示A组和B组在内膜增生的规则性和厚度方面存在统计学差异。B组显示内膜中度且规则增厚，血管滋养管增多。这表明使用收缩网可将静脉移植物的扩张及随后的损伤降至最低。将被这种收缩网包裹的大隐静脉移植物植入4例患者体内。在置入网之前，静脉直径分别为5、4.3、3.5和3.5毫米。置入网之后，静脉直径分别为4.3、3.5、2.8和2.5毫米。2个月后进行的血管造影显示移植物通畅，管径规则。
