Greisler H P, Kim D U, Dennis J W, Klosak J J, Widerborg K A, Endean E D, Raymond R M, Ellinger J
J Vasc Surg. 1987 Apr;5(4):572-83. doi: 10.1067/mva.1987.avs0050572.
This study evaluated morphologic and functional characteristics of tissue reactions to compound prostheses of 69% absorbable polyglactin 910 (PG910) and 31% nonabsorbable polypropylene in the rabbit. Forty-two woven PG910/polypropylene prostheses (24 X 4 mm internal diameter) implanted into rabbit infrarenal aortas were harvested after 2 weeks to 12 months. Each explant was photographed and sectioned for light microscopy and transmission and scanning electron microscopy. Randomly selected explants underwent either compliance and bursting strength measurements or assays of production of prostacyclin and thromboxane metabolites by luminal surfaces of both regenerated conduits and normal control aortas in response to administered sodium arachidonate. Results showed 100% patency with no aneurysms and 2% stenoses (1 of 42 prostheses). Confluent endothelial-like cellular luminal surfaces covering oriented smooth muscle-like myofibroblasts comprised the inner capsules whose thicknesses stabilized at 1 to 2 months. Only residual polypropylene remained in the prostheses after 2 months. Compliance studies reflected a 0.65 mm (14%) change over a pressure range of 0 to 160 mm Hg. All regenerated prosthesis-tissue complexes had bursting strengths greater than the proximal perianastomotic native aortas, which burst between 600 and 2000 mm Hg. At 1 month the rate of production of 6-keto-PGF1 alpha per square millimeter of surface area of experimental segments was normal. Production of 6-keto-PGF1 alpha by experimental segments at 3 months had increased fourfold whereas thromboxane B2 (TxB2) production remained unchanged. The 6-keto-PGF1 alpha/TxB2 ratio increased from 1 to 4 months. This study demonstrates clinically efficacious morphologic, mechanical, and biochemical characteristics of PG910/polypropylene-elicited vascular prosthesis-tissue complexes.
本研究评估了兔体内69%可吸收聚乙醇酸910(PG910)与31%不可吸收聚丙烯复合假体组织反应的形态学和功能特征。将42个编织的PG910/聚丙烯假体(内径24×4mm)植入兔肾下腹主动脉,2周后至12个月后取出。每个取出物进行拍照,并切片用于光学显微镜、透射电子显微镜和扫描电子显微镜观察。随机选择的取出物进行顺应性和破裂强度测量,或对再生管道和正常对照主动脉管腔表面给予花生四烯酸钠后前列腺素I2和血栓素代谢产物的生成进行测定。结果显示通畅率为100%,无动脉瘤形成,狭窄率为2%(42个假体中有1个)。覆盖定向平滑肌样肌成纤维细胞的融合内皮样细胞管腔表面构成内囊,其厚度在1至2个月时稳定。2个月后假体中仅残留聚丙烯。顺应性研究表明,在0至160mmHg的压力范围内变化为0.65mm(14%)。所有再生的假体-组织复合物的破裂强度均大于近端吻合口周围的天然主动脉,天然主动脉在600至2000mmHg之间破裂。1个月时,实验段每平方毫米表面积的6-酮-前列腺素F1α生成率正常。3个月时实验段6-酮-前列腺素F1α的生成增加了四倍,而血栓素B2(TxB2)的生成保持不变。6-酮-前列腺素F1α/TxB2比值从1个月到4个月增加。本研究证明了PG910/聚丙烯诱导的血管假体-组织复合物在临床上有效的形态学、力学和生化特征。