Chen C, Ofenloch J C, Yianni Y P, Hanson S R, Lumsden A B
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, 30322, USA.
J Surg Res. 1998 Jul 1;77(2):119-25. doi: 10.1006/jsre.1998.5399.
In an attempt to reduce platelet deposition and inhibit neointimal hyperplasia, we evaluated the effect of coating expanded polytetrafluoroethylene (ePTFE) grafts with phosphorylcholine (PC), a lipid found in animal cell membranes, in a dog model of femoral arteriovenous (AV) grafts. Eight mongrel dogs underwent placement of a PC-coated femoral AV graft on one side and an untreated control graft on the contralateral side. Platelet deposition was measured by autologous 111Indium-labeling and scintillation camera imaging analysis. Platelet deposition on the PC-coated grafts at 30 and 90 min. was 9.32 +/- 4.35 x 10(9) and 10.00 +/- 4.38 x 10(9), respectively, as compared with 10.26 +/- 4.36 x 10(9) and 11.64 +/- 5.08 x 10(9) platelet deposition on control grafts (P < 0.05). All grafts were patent at 4 weeks. There was a significant reduction of neointimal area at both arterial (0.07 +/- 0.05 mm2) and venous (0. 18 +/- 0.09 mm2) anastomoses in the treated grafts as compared with arterial (0.15 +/- 0.05 mm2) and venous (0.43 +/- 0.22 mm2) anastomoses in the control grafts (P < 0.05). In addition, neointimal cell proliferation assayed by bromodeoxyuridine (BrdU) incorporation was reduced in both arterial (2.05 +/- 0.81%) and venous (3.25 +/- 0.17%) anastomoses of treated grafts compared with arterial (3.12 +/- 1.23%) and venous (5.36 +/- 1.18%) anastomoses of control grafts (P < 0.05). These data demonstrated that PC coating of ePTFE grafts significantly reduced platelet deposition, anastomotic neointimal hyperplasia, and neointimal cell proliferation in a dog model of AV grafts. This may represent a new strategy for prolonging hemodialysis graft patency.
为了减少血小板沉积并抑制内膜增生，我们在犬股动静脉（AV）移植模型中评估了用磷脂酰胆碱（PC，一种存在于动物细胞膜中的脂质）包被膨体聚四氟乙烯（ePTFE）移植物的效果。8只杂种犬一侧植入PC包被的股AV移植物，对侧植入未处理的对照移植物。通过自体111铟标记和闪烁相机成像分析来测量血小板沉积。PC包被移植物在30分钟和90分钟时的血小板沉积分别为9.32±4.35×10⁹和10.00±4.38×10⁹，而对照移植物的血小板沉积为10.26±4.36×10⁹和11.64±5.08×10⁹（P<0.05）。所有移植物在4周时均保持通畅。与对照移植物的动脉（0.15±0.05mm²）和静脉（0.43±0.22mm²）吻合口相比，处理后移植物的动脉（0.07±0.05mm²）和静脉（0.18±0.09mm²）吻合口的内膜面积显著减小（P<0.05）。此外，与对照移植物的动脉（3.12±1.23%）和静脉（5.36±1.18%）吻合口相比，处理后移植物的动脉（2.05±0.81%）和静脉（3.25±0.17%）吻合口通过溴脱氧尿苷（BrdU）掺入法检测的内膜细胞增殖减少（P<0.05）。这些数据表明，在犬AV移植模型中，PC包被的ePTFE移植物显著减少了血小板沉积、吻合口内膜增生和内膜细胞增殖。这可能代表了一种延长血液透析移植物通畅性的新策略。
