Wu M H, Shi Q, Kouchi Y, Onuki Y, Ghali R, Yoshida H, Kaplan S, Sauvage L R
Hope Heart Institute, Providence Seattle Medical Center, WA 98122, USA.
J Vasc Surg. 1997 Mar;25(3):528-36. doi: 10.1016/s0741-5214(97)70264-7.
The purpose of this study was to develop a cost-effective canine graft healing model that gives information on various implant sites and controls for variable factors between graft locations and between animals and to compare the influence of implant site (retropleural, retroperitoneal, and subcutaneous areas) on arterial graft healing in the same subject under such controlled study conditions.
Five mongrel dogs were studied for 8 weeks, and one was studied for 3 years. Each received three porous Dacron grafts during the same surgery: a carotid-femoral bypass (C-FB) and interposition grafts in the descending thoracic aorta and abdominal aorta. To produce comparable shear stress calibers of the C-FB and abdominal aorta grafts were 2 mm less than those of the descending thoracic aorta, and a distal arterio-venous fistula was created to further increase the C-FB flow. For comparable blood aggregation status platelet aggregation was preevaluated and adjusted with antiplatelet agents. Graft flow surfaces were assessed for thrombus-free surface and endothelial-like cell coverage scores. Tissue samples were studied with hematoxylin-eosin, factor VIII/ von Willebrand factor, smooth muscle alpha-actin staining, and scanning electron microscopy and transmission electron microscopy.
All grafts were patent. Shear stress for the three grafts and platelet aggregation among the study subjects were comparable. Healing of descending thoracic aorta and abdominal aorta grafts was similar, but C-FB healing was slow, incomplete, and uneven, with a high incidence of seroma. Eight-week and 3-year results were comparable.
This model gives broad healing information about the areas where grafts are often implanted in humans. Eight weeks appears to be a sufficient period to reflect basic and general healing characteristics. Grafts heal better in the retropleural and retroperitoneal areas than in the subcutaneous tissues.
本研究的目的是建立一种具有成本效益的犬类移植物愈合模型，该模型可提供有关各种植入部位的信息，并控制移植物位置之间以及动物之间的可变因素，并在这种受控研究条件下比较植入部位（胸膜后、腹膜后和皮下区域）对同一受试者动脉移植物愈合的影响。
对5只杂种犬进行了8周的研究，对1只犬进行了3年的研究。每只犬在同一手术中接受了三个多孔涤纶移植物：一个颈动脉-股动脉旁路移植（C-FB）以及降主动脉和腹主动脉的间置移植物。为了产生可比的剪切应力，C-FB和腹主动脉移植物的口径比降主动脉的口径小2毫米，并建立了远端动静脉瘘以进一步增加C-FB的血流量。为了获得可比的血液聚集状态，预先评估了血小板聚集情况并用抗血小板药物进行了调整。评估移植物血流表面的无血栓表面和内皮样细胞覆盖评分。用苏木精-伊红、因子VIII/血管性血友病因子、平滑肌α-肌动蛋白染色以及扫描电子显微镜和透射电子显微镜对组织样本进行研究。
所有移植物均保持通畅。三个移植物的剪切应力以及研究对象之间的血小板聚集情况具有可比性。降主动脉和腹主动脉移植物的愈合情况相似，但C-FB愈合缓慢、不完全且不均匀，血清肿发生率高。8周和3年的结果具有可比性。
该模型提供了有关人类经常植入移植物区域的广泛愈合信息。8周似乎足以反映基本和一般的愈合特征。移植物在胸膜后和腹膜后区域的愈合情况比在皮下组织中更好。
