Megerman J, Hamilton G, Schmitz-Rixen T, Abbott W M
Vascular Research Laboratories, Massachusetts General Hospital, Boston 02114.
J Vasc Surg. 1993 Nov;18(5):827-34. doi: 10.1067/mva.1993.44787.
Polybutester suture is more easily stretched than other vascular sutures and may produce more compliant anastomoses. The effects of using polybutester and polypropylene sutures were compared acutely in arterial autografts and in chronic implants of cephalic vein grafts into the femoral arteries of dogs.
Paraanastomotic profiles of diameter and compliance were measured with echo-tracked ultrasonography, and profiles of intimal thickening were generated from histologic sections of the vessels harvested after 3 months.
Polybutester produced more compliant anastomoses, compared with polypropylene, in arterial autografts (in vitro: 5.9% +/- 2.0% vs 3.3% +/- 0.6% diameter change/100 mm Hg, p < 0.01; in vivo: 3.1% +/- 1.1% vs 1.6% +/- 0.5%, p < 0.05), but this difference was not observed with vein as the graft material, either initially (1.1% +/- 1.2% vs 1.7% +/- 0.5%) or after 3 months (2.1% +/- 1.2% vs 2.4% +/- 0.8%). This dichotomy may reflect a governing influence of the stiffer veingrafts, compared with host artery (2.6% +/- 1.0% vs 5.4% +/- 1.2%), or the use of suboptimal tension on the polybutester suture when creating the anastomosis.
Both sutures produced similar compliance and thickness profiles. Polybutester initially produces a more compliant anastomosis when both artery and graft are compliant, reducing anastomotic compliance mismatch. However, this benefit may not apply when the anastomosis includes a vessel of low compliance.
聚丁酯缝线比其他血管缝线更容易拉伸，可能产生更顺应性的吻合口。在狗的动脉自体移植以及头静脉移植物慢性植入股动脉中，对使用聚丁酯和聚丙烯缝线的效果进行了急性比较。
使用超声跟踪超声检查测量吻合口旁的直径和顺应性轮廓，并从3个月后采集的血管组织学切片生成内膜增厚轮廓。
在动脉自体移植中，与聚丙烯相比，聚丁酯产生更顺应性的吻合口（体外：直径变化/100 mmHg为5.9%±2.0%对3.3%±0.6%，p<0.01；体内：3.1%±1.1%对1.6%±0.5%，p<0.05），但以静脉作为移植材料时，无论是最初（1.1%±1.2%对1.7%±0.5%）还是3个月后（2.1%±1.2%对2.4%±0.8%）均未观察到这种差异。这种二分法可能反映了与宿主动脉相比（2.6%±1.0%对5.4%±1.2%），较硬的静脉移植物的主导影响，或者在创建吻合口时对聚丁酯缝线使用了次优张力。
两种缝线产生的顺应性和厚度轮廓相似。当动脉和移植物都具有顺应性时，聚丁酯最初会产生更顺应性的吻合口，减少吻合口顺应性不匹配。然而，当吻合口包括顺应性低的血管时，这种益处可能不适用。
