Gloviczki P, Hollier L H, Dewanjee M K, Trastek V F, Hoffman E A, Kaye M P
Surgery. 1984 Jun;95(6):657-66.
To evaluate factors influencing graft patency in the venous system, we replaced the inferior vena cava (IVC) in 50 dogs. Expanded polytetrafluoroethylene ( ePTFE ) grafts with external support were implanted into 32 animals while autogenous, spiral jugular vein grafts were used to replace the IVC in 18 dogs. 111In-labeled autologous platelets and 125I-labeled canine fibrinogen were utilized to evaluate early thrombus formation. A distal arteriovenous (AV) fistula significantly (P less than 0.05) decreased both platelet and fibrin deposition on ePTFE grafts 3 hours following implantation. Patency rate of 12 ePTFE grafts with a temporary AV fistula was higher (75%) than that of grafts without fistula (25%) at 3 months (P less than 0.05). Spiral vein grafts with fistula showed 91% patency at 3 months; without fistula patency was only 67%. Venograms confirmed patency in five grafts followed up to 6 months. Antiplatelet therapy resulted in 100% patency in ePTFE and vein grafts during its administration, and vein grafts maintained patency after discontinuation of antiplatelet treatment. Spiral vein grafts showed no decrease in cross-sectional area at 3 months, while the cross-sectional area of ePTFE grafts decreased significantly (59%). Distal AV fistula decreases platelet and fibrin deposition leading to early occlusion in ePTFE grafts and produces excellent patency in spiral vein grafts. Antiplatelet therapy appears to further improve patency.
为评估影响静脉系统移植物通畅性的因素，我们对50只犬的下腔静脉（IVC）进行了置换。将带有外部支撑的膨体聚四氟乙烯（ePTFE）移植物植入32只动物体内，同时使用自体螺旋颈静脉移植物置换18只犬的下腔静脉。利用111In标记的自体血小板和125I标记的犬纤维蛋白原来评估早期血栓形成情况。植入后3小时，远端动静脉（AV）瘘显著（P小于0.05）减少了ePTFE移植物上的血小板和纤维蛋白沉积。3个月时，12条带有临时AV瘘的ePTFE移植物的通畅率（75%）高于无瘘移植物（25%）（P小于0.05）。有瘘的螺旋静脉移植物在3个月时通畅率为91%；无瘘时通畅率仅为67%。静脉造影证实5条随访至6个月的移植物通畅。抗血小板治疗期间，ePTFE和静脉移植物的通畅率均为100%，停用抗血小板治疗后静脉移植物仍保持通畅。螺旋静脉移植物在3个月时横截面积未减小，而ePTFE移植物的横截面积显著减小（59%）。远端AV瘘减少血小板和纤维蛋白沉积，导致ePTFE移植物早期闭塞，并使螺旋静脉移植物具有极佳的通畅率。抗血小板治疗似乎可进一步提高通畅率。
