Wagner E, Guidoin R, Marois M, Mantovani D, Roy R, Ricci M, Marois Y, King M W, Gill F, Awad J A
Department of Medicine, Laval University Quebec City, Quebec, Canada.
ASAIO J. 1994 Jul-Sep;40(3):M279-83. doi: 10.1097/00002480-199407000-00008.
Surgically explanted vascular grafts, including 47 autografts, 14 allografts, 103 chemically processed human umbilical vein (HUV) grafts, and 406 polytetrafluoroethylene (PTFE) grafts, were studied histopathologically. Autografts, HUV, and PTFE grafts were implanted mostly in the femoropopliteal position, whereas allografts were used as a blood access for hemodialysis. The main cause for explantation in autografts (53.6%), HUV (74.8%), and PTFE (61.3%) was thrombosis, whereas allograft failure was usually related to aneurysmal degeneration (72.7%). The infection rates of HUV (20.9%) and PTFE (25%) grafts were higher than those of autografts (4.8%) and allografts (9.1%). Furthermore, bacterial colonization occurred more frequently in HUV (63.9%) and PTFE (64.7%) than in autografts (6.7%) and allografts (0%). Leukocyte infiltration was detected mostly in HUV (39.4%) and PTFE (27%) explants. Autografts and allografts both showed a 7.1% rate of lipid uptake, whereas lipid retention was observed in 84.9% of HUV and 79.8% of PTFE grafts. These results suggest that biologic vascular grafts are to be used preferentially in small diameter arterial reconstruction because of their resistance to bacterial colonization and lipid uptake.
对手术切除的血管移植物进行了组织病理学研究，包括47个自体移植物、14个同种异体移植物、103个经化学处理的人脐静脉（HUV）移植物和406个聚四氟乙烯（PTFE）移植物。自体移植物、HUV移植物和PTFE移植物大多植入股腘部位，而异种异体移植物用作血液透析的血管通路。自体移植物（53.6%）、HUV移植物（74.8%）和PTFE移植物（61.3%）切除的主要原因是血栓形成，而异种异体移植物失败通常与动脉瘤变性有关（72.7%）。HUV移植物（20.9%）和PTFE移植物（25%）的感染率高于自体移植物（4.8%）和同种异体移植物（9.1%）。此外，HUV移植物（63.9%）和PTFE移植物（64.7%）中细菌定植比自体移植物（6.7%）和同种异体移植物（0%）更频繁。白细胞浸润大多在HUV移植物（39.4%）和PTFE移植物（27%）切除物中检测到。自体移植物和同种异体移植物的脂质摄取率均为7.1%，而在84.9%的HUV移植物和79.8%的PTFE移植物中观察到脂质潴留。这些结果表明，生物血管移植物因其对细菌定植和脂质摄取的抵抗力，应优先用于小直径动脉重建。
