Guidoin R, Roy P E, Langeron P, Puppinck P, Paynter R, Gosselin C
Laboratoire d'Analyses Fonctionnelles, Hôpital Saint-François d'Assise, Québec, Canada.
J Mal Vasc. 1987;12(4):329-33.
The authors report two clinical cases of the failure due to fibrous hyperplasia of processed human umbilical vein (HUV) grafts employed as femoro-popliteal bypasses. Failure occurred after 19 months implantation at the proximal anastomosis for one graft and after 10 months at the distal anastomosis for the other. Fibrous hyperplasia was the principal cause of reoperation. The lightly vascularized, more or less compacted fibrin involved, adhering loosely to the HUV, remains thrombogenic at the blood-contacting surface. Superposed onto this phenomenon which is widespread in laboratory animals but uncommon in humans, are the usual causes of failure: delamination of the HUV wall, lipid uptake and bacterial colonization.
作者报告了两例临床病例,使用经处理的人脐静脉(HUV)移植物作为股腘动脉旁路移植时因纤维增生导致失败。其中一个移植物在植入19个月后于近端吻合口处发生失败,另一个在植入10个月后于远端吻合口处失败。纤维增生是再次手术的主要原因。轻度血管化、或多或少致密的纤维蛋白参与其中,松散地附着于HUV,在血液接触表面仍具有血栓形成性。除了这种在实验动物中普遍存在但在人类中不常见的现象外,还有常见的失败原因:HUV壁分层、脂质摄取和细菌定植。