Urayama H, Kawakami K, Kasashima F, Watanabe Y, Katsuda S
Department of Surgery, Kanazawa University School of Medicine, Japan.
Minerva Cardioangiol. 1995 Jul-Aug;43(7-8):293-7.
We studied woven dacron grafts that had been implanted in 5 patients of thoracic aortic aneurysms. In addition to usual stains, immunocytochemical analysis was performed using monoclonal antibodies to the muscle actin (HHF35) and to the macrophage (HAM56). In the graft of 5 and 24 days implantation, thin thrombi containing red cells and fibrin covered the luminal surface in some places, and macrophages came into the thrombi. In the grafts of 12 and 38 months implantation, intimal hyperplasia of 0.2-1.0 mm thickness was seen at the anastomotic segments with the accumulation of smooth muscle cells. Except for the anastomotic segments, connective tissue matrix with collagen fibers covered the luminal surface, and in some hollows of the graft crimps, old and fresh thombi were seen in layers. Organizing thrombi of 1.0 mm thickness attached where the branched graft was anastomosed to the main graft. Anastomotic intimal hyperplasia in the graft of 148 month implantation was 0.4-1.0 mm in thickness and 5-10 mm in length, and aside from the intimal hyperplasia, an endothelial lining did not cover the luminal surface of the graft. In the thoracic aorta, woven dacron graft implantation did not cause a critical stenosis with the intimal hyperplasia. The mural thrombi formed at the branched graft, however, threatened to result in graft occlusion or embolization.
我们研究了植入5例胸主动脉瘤患者体内的机织涤纶移植物。除常规染色外，还使用针对肌肉肌动蛋白（HHF35）和巨噬细胞（HAM56）的单克隆抗体进行免疫细胞化学分析。在植入5天和24天的移植物中，某些部位的管腔表面覆盖着含有红细胞和纤维蛋白的薄血栓，且有巨噬细胞进入血栓。在植入12个月和38个月的移植物中，吻合段可见厚度为0.2 - 1.0毫米的内膜增生，伴有平滑肌细胞积聚。除吻合段外，管腔表面覆盖着含有胶原纤维的结缔组织基质，在移植物压痕的一些凹陷处可见新旧血栓分层。在分支移植物与主移植物吻合处附着有厚度为1.0毫米的机化血栓。植入148个月的移植物中吻合处内膜增生厚度为0.4 - 1.0毫米，长度为5 - 10毫米，除内膜增生外，移植物管腔表面未被内皮覆盖。在胸主动脉中，机织涤纶移植物植入未因内膜增生导致严重狭窄。然而，在分支移植物处形成的壁血栓有导致移植物闭塞或栓塞的风险。
