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I G Kidson¹, W M Abbott

¹Vascular Research Laboratory, Department of Surgery, Harvard Medical School, The Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

|September 1, 1978

概括

动脉移植的硬度显著影响透气性. 与合成选项相比,更符合规范的移植,如软静脉,在长期内表现出更好的穿透性,这突显了在移植设计中弹性特性的重要性.

科学领域:

生物医学工程生物医学工程
血管外科血管外科
材料科学材料科学材料科学

背景情况:

早期的动脉移植失败,特别是软静脉 (1年后12-30%) 和合成移植的透气性损失,仍然是一个重大的临床挑战.
移植硬度可能会阻碍脉动的流动,扰乱能量传播,可能导致移植功能障碍.
了解动脉移植的生物力学特性对于改善长期穿透率至关重要.

研究的目的:

为了研究动脉移植的体内合规性及其长期通透性之间的关系.
在狗模型中,比较软静脉移植与合成移植 (Dacron和ePTFE) 的合规性和通透性.
为了确定移植硬度是否是早期动脉移植失败的关键因素.

主要方法:

在38个本土动脉和60个动脉移植中测量了体内合规性 (C),使用狗大腿动脉旁路模型中的压力和直径数据.
合规性表达为每毫米平面的辐射变化百分比 (x 10(2) +/- SEM).
植入后2周和3个月评估了移植的透度.

主要成果:

原生动脉 (C = 7.40 +/- 0.73) 与所有测试的移植体相比显著更符合要求 (P < 0.01).
在植入时,沙芬静脉移植 (C = 2.67 +/- 0.18) 比达克龙 (C = 1.86 +/- 0.16) 和ePTFE (C = 1.63 +/- 0.14) 移植 (P < 0.01) 更符合标准.
静脉移植透视度在2周时为83%,而达克隆为64%,EPTFE为32%. 三个月后,静脉移植的透度仍然很高,而达克龙降至29%,ePTFE降至14%. 观察到穿透率和合规性之间存在强烈的相关性.

结论:

移植合规性是动脉移植通透性的关键决定因素.
与合成达克隆和ePTFE移植相比,沙芬静脉移植表现出更高的合规性和穿透性.
未来的动脉移植设计应优先考虑弹性特性,以提高长期的移植生存和功能.

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