EFFECTS OF COMPLIANCE MISMATCH IN ARTERIAL GRAFTS

动脉移植物顺应性不匹配的影响

• 批准号: 3340538
• 负责人: WILLIAM M ABBOTT
• 金额: $ 21.75万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-09-05 至 1990-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3340538
• 关键词: antithrombogenic surface; autoradiography; biomaterial compatibility; biomaterial development /preparation; blood lipid; blood vessel prosthesis; blood vessel transplantation; elasticity; human subject; hyperplasia; infrared spectrometry; mechanical pressure; platelet aggregation; radiotracer; scanning electron microscopy; tissue /cell culture; vascular endothelium; vascular resistance; wound healing

Our original compliance hypothesis stated that some of the problems with synthetic small diameter arterial bypass graft patency are related to their lower circumferential compliance, compared to that of the host arteries. Based on theory and circumstantial experimental evidence, large commitments have now been made to the manufacture of a compliant synthetic graft. But our previous studies also suggest that compliance may only be consequential in the presence of a thrombogenic flow surface. The true importance of graft compliance is, therefore, still unclear and is the subject of this proposal. The compliance hypothesis will be tested in dogs by comparing biologic and synthetic arterial grafts of different compliance but identical controlled flow surfaces. The effects of compliance will be examined as those related to the anastomosis alone (anastomotic effects) and to the conduit itself (tubular effects) and each of these will be correlated with the morphology of the tissue-healing response, thrombus deposition and pseudointimal thickening in the graft, calcium and lipid accumulation and endothelial cell coverage. Compliance and its changes with time will be measured using pulsed ultrasound in both animals and man. The interaction of compliance mismatch and other parameters will be studied including a) host artery intimal injury; b) decreased graft wall thrombogenicity; c) more complex anastomotic flow geometry (end-to-side anastomosis); and d) increased platelet reactivity and blood coagulability. Finally, we will study ways of eliminating the anatomotic effects of compliance mismatch and develop improved design criteria for optimum tubular compliance. These studies will lead to an expanded understanding of the mechanism of failures of small vessel grafts and to an improvement in the results with such grafts.

我们最初的合规假设指出，一些问题 合成小直径动脉旁路移植物的通畅性与其相关 与宿主动脉相比，周向顺应性较低。 基于理论和间接实验证据，大量承诺 现在已用于制造顺应性的合成移植物。 但 我们之前的研究还表明，合规性可能只是结果 在存在血栓形成的流动表面的情况下。 真正的重要性 因此，移植物顺应性仍不清楚，也是本文的主题 提议。 顺从假设将通过比较在狗身上进行测试 生物和合成动脉移植物的顺应性不同，但 相同的受控流动表面。 合规性的影响将是 与仅与吻合相关的检查（吻合效应） 以及导管本身（管状效应），其中每一个都将是 与组织愈合反应、血栓的形态相关 移植物、钙和脂质中的沉积和假内膜增厚 积累和内皮细胞覆盖。 合规性及其变化 将使用脉冲超声波在动物和动物身上测量随时间的变化 男人。 顺应性不匹配和其他参数的相互作用将是 研究内容包括a)宿主动脉内膜损伤； b) 移植物壁减少 血栓形成性； c) 更复杂的吻合血流几何形状（端对侧 吻合术）； d) 增加血小板反应性和血液 凝固性。 最后，我们将研究消除解剖学问题的方法 合规性不匹配的影响并制定改进的设计标准 最佳的管状顺应性。 这些研究将导致扩大 了解小血管移植失败的机制并 此类移植物的结果得到改善。