Crowe D M, Hurley J V, Mitchell G M, Niazi Z, Morrison W A
Bernard O'Brien Institute of Microsurgery, St Vincent's Hospital, Melbourne, Australia.
Br J Plast Surg. 1998 Jun;51(4):291-9. doi: 10.1054/bjps.1998.0020.
In previous studies we have shown that 80-100% of rabbit femoral vascular autografts cold-stored at 4 degrees C for 3 weeks remain patent 3 weeks after reinsertion in the femoral artery. The present study reports the effect on graft patency of increasing either the period of cold storage prior to reinsertion or the duration of reperfusion to 6 months. Rabbit femoral blood vessels were cold-stored (CS) at 4 degrees C for varying periods. CS autografts were reinserted into the contralateral leg for 3 weeks or 6 months. Graft patency was determined and grafts examined by histological, immunohistochemical and electron microscopical techniques. Six months after reinsertion patency of 4-week CS arterial and 1-week CS venous grafts was 40% and 27% respectively, very much lower than the 80-100% seen after 3 weeks reperfusion. Arterial grafts CS for 6 months had a patency rate of 70% after 3 weeks reperfusion but 0% after 6 months. Morphological examination suggests that the delayed failure of cold-stored vascular grafts is caused by thrombus superimposed on intimal hyperplasia within the graft.
Cold-stored vascular grafts are useful prostheses when only 3-4 weeks graft patency is required. They are not suitable for use when long-term graft patency is needed.
在先前的研究中我们已经表明,4℃冷藏3周的兔股血管自体移植血管在重新植入股动脉3周后仍有80%-100%保持通畅。本研究报告了在重新植入前增加冷藏时间或再灌注时间至6个月对移植血管通畅率的影响。兔股血管在4℃下冷藏不同时间。冷藏后的自体移植血管被重新植入对侧腿部3周或6个月。测定移植血管的通畅率,并通过组织学、免疫组织化学和电子显微镜技术检查移植血管。重新植入6个月后,4周冷藏的动脉移植血管和1周冷藏的静脉移植血管的通畅率分别为40%和27%,远低于再灌注3周后的80%-100%。冷藏6个月的动脉移植血管在再灌注3周后的通畅率为70%,但在6个月后为0%。形态学检查表明,冷藏血管移植的延迟失败是由移植血管内内膜增生上叠加的血栓引起的。
当仅需要3-4周的移植血管通畅时,冷藏血管移植是有用的假体。当需要长期移植血管通畅时,它们不适合使用。