da Silva A F, Carpenter T, How T V, Harris P L
Royal Liverpool University Hospital, University of Liverpool, U.K.
Eur J Vasc Endovasc Surg. 1997 Sep;14(3):157-63. doi: 10.1016/s1078-5884(97)80185-2.
Interposition vein cuffs improve the patency of below-knee ePTFE arterial grafts, and there is evidence that they do so, at least in part, by modifying the distribution of myointimal hyperplasia (MIH) at the distal anastomosis. Alteration of local haemodynamics is one of the mechanisms which might be involved. The purpose of this study was to characterise the local haemodynamics within an interposition vein cuff.
Flow patterns have been analysed in a laboratory model of cuffed anastomosis and compared with observations made in patients by cine intra-arterial digital subtraction angiography (IA DSA) and dynamic colour duplex scanning.
In contrast to non-cuffed anastomoses in which the flow is predominantly laminar, cuffed anastomoses are associated with the formation of a coherent vortex.
High frictional forces or shear stress exerted upon the arterial wall by the vortex could explain the beneficial effect of a cuff upon anastomotic MIH, in which case the optimal configuration of small vessel anastomoses would be that which most effectively promotes the formation of this type of vortex.
静脉套入法可提高膝下膨体聚四氟乙烯（ePTFE）动脉移植物的通畅率，且有证据表明，其至少部分是通过改变远端吻合口处肌内膜增生（MIH）的分布来实现的。局部血流动力学改变可能是其中涉及的机制之一。本研究的目的是描述静脉套入法中的局部血流动力学特征。
在带套吻合的实验室模型中分析血流模式，并与通过动脉内数字减影血管造影电影（IA DSA）和动态彩色双功扫描在患者身上的观察结果进行比较。
与血流主要呈层流的无套吻合不同，带套吻合与连贯涡旋的形成有关。
涡旋对动脉壁施加的高摩擦力或剪切应力可以解释套入法对吻合口MIH的有益作用，在这种情况下，小血管吻合的最佳构型将是最有效地促进此类涡旋形成的构型。
