A Study of Anastomotic Neointimal Hyperplasia After Graft Inplantation.

移植物植入后吻合口新内膜增生的研究。

基本信息

批准号：
01570699
负责人：
SAKUMA Makoto
金额：
$ 1.02万
依托单位：
Hokkaido University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

项目摘要

Despite improvement of the vascular prostheses, the long term patency rate remains unfulfilled after small caliver graft implantation. Anastomotic neointimal hyperplasia (ANH) is known as a contributing factor of graft occlusion after implantation and the difference of mechanical properties between a vascular prosthesis and its host arteries, abnormal graft flow, intimal trauma due to surgical procedure, platelet aggregation in a surface of anastomotic site, suture material and method are suggested the factors of ANH.In this study, we investigated (1) the difference of mechanical properties between vascular grafts and host arteries. (2) small caliber(3mm in diameter) graft implantation in dogs and long term observation of the anastomotic site after implantation. (3) comparison of thrombogenecity of grafts and ANH. The results are as follows ;(1) A new type ultrasonic displacement meter was developed and compliance of arterial grafts ware measured. In comparison of compliance of human a … More rteries to that of grafts, a mismatch in compliance between grafts and arteries was obviously demonstrated.(2) In dogs, carotid artery was replaced with different compliance of graft (ePTFE, segmented polyurethane graft) 3mm in diameter and long term observation was performed. The rate of patency was good in high compliance graft (50%/1 year) but ANH was occurred both in low compliance graft and high compliant graft. Compliance mismatch between vascular prosthesis and host arteries is suggested to be one of the factor contributing ANH, but it seems to be not a main factor.(3) To evaluate relationship between platelet aggregation in a surface of graft and ANH. In^<111> platelet scintigraphy was performed in the early and late stage of graft implantation. There was significant difference of the patency rate between high platelet aggregation group and low plate let aggregation group in the early stage after implantation but there was no difference of occurrence of ANH between the two groups. Less

尽管血管假体有所改进，但小口径移植物植入后的长期通畅率仍未实现。吻合口新生内膜增生（ANH）被认为是植入后移植物闭塞以及血管假体与其宿主之间机械性能差异的一个促成因素。提示动脉血管、移植血流异常、手术造成的内膜损伤、吻合口表面血小板聚集、缝合材料和方法等因素。 ANH.在这项研究中，我们研究了（1）血管移植物和宿主动脉之间的机械性能差异（2）小口径（直径3毫米）移植物植入狗以及植入后吻合部位的长期观察（3）。）移植物与ANH的血栓形成性比较：（1）研制了新型超声位移计并测量了动脉移植物的顺应性。与人体动脉的顺应性进行了比较。 (2)用直径3mm的不同顺应性的移植物(ePTFE、分段聚氨酯移植物)代替犬的颈动脉，并进行长期观察。高顺应性移植物的通畅率良好（50%/1 年），但低顺应性移植物和高顺应性移植物均发生 ANH，这表明人工血管与宿主动脉之间的顺应性不匹配。是造成ANH的因素之一，但似乎不是主要因素。(3)为评价移植物表面血小板聚集与ANH的关系，在移植物早期和晚期进行了In^<111>血小板闪烁扫描。移植物植入后早期，高血小板聚集组和低血小板聚集组的通畅率有显着差异，但两组之间ANH的发生率无差异。