Granke K, Ochsner J L, McClugage S G, Zdrahal P
Department of Surgery, West Virginia University Hospitals, Morgantown.
Cardiovasc Surg. 1993 Jun;1(3):254-61.
The need for a vascular prosthesis that does not require preclotting is apparent. The use of biological biodegradable coatings may carry the potential disadvantages of undesirable healing, inflammatory or antigenic reactions, and increased thrombogenicity. A graft has been developed to minimize porosity by coating only the outer surface with a bioinert non-absorbable elastomer (mainly Silastic) so as to leave the inner surface unchanged. Thoracoabdominal aortic 8-mm grafts (ten knitted and five woven coated grafts, six uncoated Dacron grafts) 12 cm long were implanted in mongrel dogs for 6 months. Differences in patency and healing in coated and uncoated grafts were observed by angiography, and by scanning electron and light microscopy. Statistical analysis included Fisher's exact test and Student's unpaired t test. Clinically, no ill effects were noted in coated grafts, and the transinterstitial blood loss was similar to that in preclotted uncoated grafts. One graft in each group occluded for technical reasons. One knitted coated graft developed perigraft seroma. The woven coated grafts and control prostheses had similar handling properties; however, needles appeared to pass through the coated graft material more easily and with less suture drag. Scanning electron microscopy was used to demonstrate similar presence of endothelial-like cells in both groups. Comparisons between coated and control grafts using light microscopy were as follows: pseudoendothelium, 0.26 versus 0.31 mm (P not significant); inflammation, 0.21 versus 0.73 (P < 0.01); giant cell formation, 0.02 versus 0.80 (P < 0.01); fibrosis, 1.31 versus 1.80 (P < 0.03). Tissue ingrowth into and around the Dacron fibers from the outer surface was similar.(ABSTRACT TRUNCATED AT 250 WORDS)
显然需要一种无需预凝血的血管假体。使用生物可降解涂层可能存在不良愈合、炎症或抗原反应以及血栓形成增加等潜在缺点。已开发出一种移植物，通过仅用生物惰性不可吸收弹性体（主要是硅橡胶）涂覆外表面来最小化孔隙率，从而使内表面保持不变。将12厘米长的8毫米胸腹主动脉移植物（十个针织和五个编织涂层移植物，六个未涂层的涤纶移植物）植入杂种狗体内6个月。通过血管造影、扫描电子显微镜和光学显微镜观察涂层和未涂层移植物在通畅性和愈合方面的差异。统计分析包括费舍尔精确检验和学生未配对t检验。临床上，涂层移植物未观察到不良影响，跨间隙失血与预凝血未涂层移植物相似。每组中有一个移植物因技术原因闭塞。一个针织涂层移植物出现了移植物周围血清肿。编织涂层移植物和对照假体具有相似的操作特性；然而，针似乎更容易穿过涂层移植物材料，且缝合阻力较小。扫描电子显微镜用于证明两组中均存在类似内皮样细胞。使用光学显微镜对涂层和对照移植物进行的比较如下：假内皮，0.26对0.31毫米（P无显著性差异）；炎症，0.2比对0.73（P<0.0）；巨细胞形成，0.02对0.80（P<0.01）；纤维化，1..31对1.80（P<0.03）。从外表面向涤纶纤维内及周围的组织长入情况相似。（摘要截断于250字）
