Akiyama N, Esato K, Fujioka K, Zempo N
First Department of Surgery, Yamaguchi University School of Medicine, Japan.
Surg Today. 1997;27(9):840-5. doi: 10.1007/BF02385275.
The utility of CORVITA vascular grafts, composed of an inner layer of meshed polyurethane fibers and an outer layer of meshed Dacron reinforcement, for replacement of the abdominal aorta was assessed in a canine model and compared with expanded polytetrafluoroethylene (ePTFE) grafts. CORVITA or ePTFE vascular grafts were implanted and left in place for 3 or 6 months. After removal, they were inspected macroscopically and histologically. Microspectrophotometry was used to quantify smooth muscle cells (SMCs), elastin (EL), and collagen (CL) in the media of the native artery. The patency rate of the CORVITA grafts after 6 months was 100%, whereas that of the ePTFE grafts was only 50%. Moreover, stenoses were apparent in all of the ePTFE grafts, but in only 43% of the CORVITA grafts. The intimal thickness at the distal anastomosis was significantly greater at 3 months in the ePTFE grafts (P < 0.01), and there were significantly more SMCs in the host arterial media at the proximal and distal anastomoses in these grafts. Thus, better long-term patency can be expected with CORVITA grafts than with ePTFE grafts. This conferred advantage is most likely attributable to the less pronounced intimal hyperplasia which results from the proliferation of SMCs in the media of the native artery.
在犬类模型中评估了由网状聚氨酯纤维内层和网状涤纶增强外层组成的CORVITA血管移植物用于替换腹主动脉的效用,并与膨体聚四氟乙烯(ePTFE)移植物进行了比较。植入CORVITA或ePTFE血管移植物并留置3或6个月。取出后,对其进行宏观和组织学检查。使用显微分光光度法对天然动脉中膜的平滑肌细胞(SMC)、弹性蛋白(EL)和胶原蛋白(CL)进行定量。6个月后CORVITA移植物的通畅率为100%,而ePTFE移植物的通畅率仅为50%。此外,所有ePTFE移植物均出现狭窄,而CORVITA移植物仅43%出现狭窄。ePTFE移植物在3个月时远端吻合口处的内膜厚度显著更大(P < 0.01),并且这些移植物近端和远端吻合口处宿主动脉中膜的SMC明显更多。因此,与ePTFE移植物相比,CORVITA移植物有望实现更好的长期通畅性。这种赋予的优势很可能归因于天然动脉中膜SMC增殖导致的内膜增生不明显。