Schürmann K, Vorwerk D, Rosenbaum C, Eckert K, Biesterfeld S, Stopinski T, Günther R W
Department of Diagnostic Radiology, University of Technology, Aachen, Germany.
Cardiovasc Intervent Radiol. 1995 Jul-Aug;18(4):233-8. doi: 10.1007/BF00239418.
Evaluate the feasibility of expanding arterial and venous stents incorporated into the vessel wall by surgical patch-plasty in an experimental study.
An 8-mm Wallstent was percutaneously implanted into the carotid artery of 11 sheep and into the ipsilateral jugular vein in three of them. Three months after implantation, a patch-plasty was performed on the incorporated stents using a 0.4-mm-thick synthetic patch made of polytetrafluoroethylene (PTFE). Stent patency was monitored by color-coded duplex ultrasound and angiography for 6 months after operation.
No suture dehiscence or aneurysm formation were observed. Nine of 11 arterial and 2 of 3 venous stents remained fully patent during follow-up. In arteries, complications encountered were a complete stent thrombosis early after surgery, as well as a floating thrombus in the stent, found at final angiography after 6 months. In veins, one partial stent thrombosis was observed. Microradiographic and histological examinations revealed marked intimal hyperplasia in both arterial and venous stents. Intimal hyperplasia was significantly more pronounced in patched than in stented arterial segments (p < 0.005).
Patch-plasty surgery of previously incorporated vascular stents is technically feasible. Mid-term patency rates were acceptable.
在一项实验研究中评估通过手术补片成形术将动脉和静脉支架扩展至血管壁内的可行性。
将一个8毫米的Wallstent支架经皮植入11只绵羊的颈动脉，其中3只还植入了同侧颈静脉。植入3个月后，使用由聚四氟乙烯（PTFE）制成的0.4毫米厚的合成补片对已嵌入的支架进行补片成形术。术后通过彩色编码双功超声和血管造影监测支架通畅情况6个月。
未观察到缝线裂开或动脉瘤形成。11个动脉支架中的9个和3个静脉支架中的2个在随访期间保持完全通畅。在动脉中，术后早期出现了一次完全的支架血栓形成，以及在6个月后的最终血管造影中发现支架内有漂浮血栓。在静脉中，观察到一次部分支架血栓形成。显微放射摄影和组织学检查显示动脉和静脉支架内均有明显的内膜增生。补片处理的动脉段内膜增生比单纯支架置入的动脉段明显更显著（p < 0.005）。
对先前已嵌入的血管支架进行补片成形术在技术上是可行的。中期通畅率是可以接受的。
