Becquemin J P, Deleuze P, Léandri J, Lautier A, Mellière D
J Mal Vasc. 1984;9(2):90-4.
This study was designed to evaluate intimal hyperplasia distal to the suture line in two types of vascular anastomosis: end to end and end to side. 49 aorto-iliac homografts have been performed on rabbits New-Zealand. The aortic anastomosis was side to end, iliac anastomosis were end to end on one side, end to side on the other one. Scanning electronic microscopical study and histological evaluation were carried out at various time of survival from 2 hours to 180 days. The scanning microscopy has evidenced the surface changes: early platelets adhesion and the healing process. Histological evaluation demonstrated that the intimal proliferation was prevailing at the level of the suture line in both anastomosis, and at the opposite to the mouth of the anastomosis in the end to side one. Intimal thickness was measured on arterial section immediately distal to the suture line. In the end to end anastomosis, hyperplasia was absent on the 5th post-operative days, it reached 120 mu +/- 33 on the 40th days, and decreased to 40 mu +/- 35 on the 150th post-operative day. In the end to side anastomosis evolution was the same: 0 mu on the 5th, 106 mu +/- 49 on the 40th day and 53 mu +/- 45 on the 150th post-operative day. In conclusion, this experimental study gives some support to the fact that the type of anastomosis, per se, end to side or end to end does not influence the development of intimal hyperplasia.
本研究旨在评估两种血管吻合方式(端端吻合和端侧吻合)吻合口远端的内膜增生情况。对49只新西兰兔进行了主动脉-髂动脉同种异体移植。主动脉吻合为端侧吻合,一侧髂动脉吻合为端端吻合,另一侧为端侧吻合。在术后2小时至180天的不同存活时间进行扫描电子显微镜研究和组织学评估。扫描显微镜观察到了表面变化:早期血小板黏附及愈合过程。组织学评估表明,两种吻合方式在吻合口处内膜增生均较为明显,在端侧吻合时,内膜增生在吻合口对侧更为显著。在内膜厚度测量方面,于吻合口远端的动脉切片上进行测量。在端端吻合中,术后第5天未见增生,术后第40天增生厚度达到120μm±33μm,术后第150天降至40μm±35μm。在端侧吻合中,变化情况相同:术后第5天为0μm,术后第40天为106μm±49μm,术后第150天为53μm±45μm。总之,本实验研究支持以下事实:吻合方式本身,无论是端侧吻合还是端端吻合,均不影响内膜增生的发展。