Ochsner J L, Lawson J D, Eskind S J, Mills N L, DeCamp P T
J Vasc Surg. 1984 Mar;1(2):306-13. doi: 10.1067/mva.1984.avs0010306.
From 1968 through 1982, 129 homologous vein grafts were used in 91 patients in the following positions: 75 in the femoropopliteal, tibial, or peroneal artery; 38 in the aortocoronary artery; 13 in the aortopulmonary artery; and one each in the atrioventricular fistula, carotid-subclavian artery, and brachial-radial artery. In the lower extremity patency ranged from 0 to 121 months (mean 22.4 +/- 4.4 months). All grafts were performed for limb salvage, and 75% of the patients had undergone previous operations. Cumulative patency by the life-table method showed that while 50% of grafts occluded by 1 year, 60% of the remaining grafts continued to be functional for more than 5 years. Fifty percent of the aortocoronary bypass grafts studied were occluded at 1 year. Eight of the 13 systemic pulmonary artery shunts were patent at time of death, revision, or total correction. Multiple revisions and thrombectomies are required to maintain patency of homograft veins. The outcome is variable and unpredictable. The inconsistency is due to the antigenicity of the graft. If one is committed to the necessary efforts required to ensure long-term patency, the homologous saphenous vein is a suitable substitute when autogenous tissue is unavailable.
从1968年至1982年，91例患者共使用了129条同种异体静脉移植物，用于以下部位：股腘动脉、胫动脉或腓动脉75条；主动脉冠状动脉38条；主动脉肺动脉13条；房室瘘、颈总动脉 - 锁骨下动脉和肱桡动脉各1条。下肢移植物通畅时间为0至121个月（平均22.4±4.4个月）。所有移植物均用于挽救肢体，75%的患者曾接受过先前手术。寿命表法计算的累积通畅率显示，50%的移植物在1年内闭塞，其余移植物中有60%在5年以上仍保持功能。所研究的主动脉冠状动脉旁路移植物中有50%在1年内闭塞。13例体肺分流术中，8例在死亡、翻修或完全矫正时仍保持通畅。需要多次翻修和血栓切除术以维持同种异体静脉移植物的通畅。结果是可变且不可预测的。这种不一致性是由于移植物的抗原性所致。如果致力于为确保长期通畅而付出必要努力，那么在自体组织无法获取时，同种异体大隐静脉是一种合适的替代物。
