Zhang F, Ustüner T, Walker R, Buntic R, Lineaweaver W C
Division of Plastic & Reconstructive Surgery, Stanford University Medical Center, CA 94305, USA.
Microsurgery. 1995;16(8):528-32. doi: 10.1002/micr.1920160804.
An experimental microvenous thrombosis model was developed combining vein grafting in femoral vein defects with exaggerated vessel injuries using a knotted suture in the vessel repair. The rat femoral vein grafts were separately subjected to injuries caused by an anastomosis performed with a suture knotted with eight half-hitches at the distal anastomosis (upstream), the proximal anastomosis (downstream), and both anastomotic sites. These groups were compared to vein grafting done with a standard suture. Vessel patency was assessed at 20 min and 24 hr, and the thrombus component was histologically analyzed at 24 hr after the procedures. One hundred percent of control vein grafts were patent at 24 hr. All experimental groups had significantly decreased patency at 24 hr (P < 0.001). Among the experimental groups, knotted suture anastomoses at both anastomoses produced significantly lower patency (13.3%, P < 0.05) than knotted suture anastomoses at distal anastomoses. Histological analyses of thrombosed grafts showed that a large amount of thrombocyte deposition and inflammatory cells were noted at both anastomotic sites in the vein grafts with a knotted suture at the distal anastomosis and in the grafts with a knotted suture at both anastomoses. Thrombocyte deposition and inflammatory cells were seen only at the site of proximal anastomosis when using a knotted suture at the proximal anastomosis site alone. This study demonstrated that quantified microvenous thrombosis can be produced by exaggerating vessel injuries with a knotted suture in a vein graft model. This thrombosis model can be used to study the effects of antithrombogenic agents.
建立了一种实验性微静脉血栓形成模型，该模型将股静脉缺损处的静脉移植与在血管修复中使用打结缝线造成的过度血管损伤相结合。将大鼠股静脉移植物分别在远端吻合口（上游）、近端吻合口（下游）以及两个吻合口处用打八个半结的缝线进行吻合，从而造成损伤。将这些组与使用标准缝线进行静脉移植的情况进行比较。在术后20分钟和24小时评估血管通畅情况，并在术后24小时对血栓成分进行组织学分析。对照组静脉移植物在24小时时100%通畅。所有实验组在24小时时的通畅率均显著降低（P<0.001）。在实验组中，两个吻合口均采用打结缝线吻合的通畅率（13.3%，P<0.05）显著低于远端吻合口采用打结缝线吻合的情况。对形成血栓的移植物进行组织学分析表明，在远端吻合口采用打结缝线的静脉移植物以及两个吻合口均采用打结缝线的移植物中，两个吻合口处均观察到大量血小板沉积和炎症细胞。仅在近端吻合口处采用打结缝线时，仅在近端吻合口处可见血小板沉积和炎症细胞。本研究表明，在静脉移植模型中通过用打结缝线造成过度血管损伤可产生定量的微静脉血栓形成。该血栓形成模型可用于研究抗血栓形成药物的作用。
