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[自体静脉移植物移植至动脉后血管壁的变化]

[Changes in the walls of autologous venous grafts after transplantation into arteries].

作者信息

Shormanov S V, Pshenisnov K P

出版信息

Arkh Anat Gistol Embriol. 1987 Jun;92(6):19-25.

PMID:3632359
Abstract

In 54 dogs 76 operations on plastics of the common carotid arteries with the femoral vein segments have been performed. The animals have been observed for 3 days--1.5 years. The grafts, preserving their permeability, have been studied using a complex of anatomical, histological and micromorphometric techniques. At early stages after the operation (up to 7 days), dystrophic and necrobiotic changes predominate in the wall of the venous graft. As a result of overstretching of the denervated and devascularized vessel, under the effect of a high arterial pressure, nearly total rejection of the endothelial lining takes place, as well as death of some smooth myocytes in the middle tunic; this determines appearance of early thromboses. During 2-6 months after the operation, against the background of a good revascularization of the graft, restorative and adaptive changes develop in its wall. The intima becomes thick at the expense of formation of the obliquely situating layer of myocytes, as well as the result of parietal thromboses organizing on the deendothelized internal surface. These thickenings are especially well seen in the zones of anastomoses. In 6 months--1.5 years after the transplantation into the artery, as a result of constriction of the vessels feeding the graft and reduction of blood stream along them, atrophic and sclerotic changes increase in the wall. The intimal thickenings often acquire the pattern of fibrous patches, that make the lumen more narrow; this can cause appearance of late occlusions and thromboses of the grafts.

摘要

对54只犬进行了76次用股静脉段对颈总动脉进行整形的手术。对这些动物进行了3天至1.5年的观察。利用解剖学、组织学和微观形态测量技术等综合方法对保持其通透性的移植物进行了研究。在术后早期(至7天),静脉移植物壁内以营养不良性和坏死性改变为主。由于去神经和去血管化血管的过度伸展,在高动脉压的作用下,内皮几乎完全脱落,中膜一些平滑肌细胞死亡;这决定了早期血栓的出现。在术后2至6个月,在移植物良好再血管化的背景下,其壁内发生修复性和适应性改变。内膜增厚是由于斜向排列的肌细胞层形成,以及在内皮化内表面组织化的壁内血栓形成所致。这些增厚在吻合区域尤为明显。在移植到动脉后6个月至1.5年,由于供应移植物的血管收缩以及沿这些血管的血流减少,壁内萎缩和硬化性改变加剧。内膜增厚常常呈现纤维斑块的形态,使管腔更狭窄;这可导致移植物晚期闭塞和血栓形成。

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[Changes in the walls of autologous venous grafts after transplantation into arteries].[自体静脉移植物移植至动脉后血管壁的变化]
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