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末梢靜脈移植에 關한 實驗的 硏究

Peripheral Venous Graft with Autogenous Artery

대한외과학회지 1968년 10권 11호 p.785 ~ 800
김형묵,
소속 상세정보
김형묵 (  ) - 서울대학교 의과대학 외과학교실

Abstract


Experimental study of peripheral venous autograft with autogenous artery was done for patency and microscopic study in the period of one to four months after grafting.
Grafts, which were obtained from canine femoral artery in a length of 2-3 cm, were anastomosed to replace the resected ipsilateral femoral vein in Group Ⅰ(total 21 cases)and proximal femoral arteriovenous fistula was created in additiotn to the autograft. The fistula was ligated after one week postoperatively in Group Ⅱ(total 12 cases).
Femoral venography at the site of grafting, measurement of venous pressure macroscopic and microscopic study were made one to four months after transplantation in the Group Ⅰ and Group Ⅱ separately.
A) Patency of the graft:
1. Patency of the graft by femoral venograhpy revealed 50% rate in Group Ⅰ and 17% in Group Ⅱ.
2. Some cavograms showed slight to moderate degree of constriction and narrowing at the site of anastomosis.
3. In cases of occlusion, remarkable collaterals were identified in femoral venography.
B) Venous pressure
1. Venous pressure was checked in every cases before and after transplantation, which revealed decreased pressure proximal and increased pressure distal to the graft, especially in cases of Group Ⅱ.
2. Distal venous pressure to the graft was decreased to normal after 3 months of observation period which might be due to increased collaterals.
C) Microscopic findings of the grafts
1. In one month group, some cases revealed slight hemorrhage with hematoma formation and slight degenerative and necrotic changes in the intimal and medial layer of the graft.
2. In two months group, significant repairing process, such as organization of the hematoma and prolifteration of connective tissue in the media and adventitia were noted.
3. In three months group, intima of the graft was almost completely repaired and no necrotic change of the granulation tissue at the site of anastomosis was observed.
4. In four months group, intima of the graft was completely covered with endothelial cells and otherwise no specific change was noted since three months group.

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