Objective To study the effect of vein-occlusion on the replanted limb survival in SD rats at different stages. Methods Twenty-five adultSD rats were randomly divided into 5 groups according to the time of the femoral vein occlusion after the replanted limbs:2- ,3- ，4 -，6-，and 8- day groups. The limbs were observed through naked eye, measurement of dermal temperature and angiography. Results No formation of collateral veinlet was found, and necrosis wasseen in the replanted limbs of 2- , 3- day groups. Reflux-vein was gradually increased in the replanted limbs of 4，6，and 8 day groups. Angiographic score of capillary density and dermal temperaturein the thigh muscles were greater in groups 4-，6-，and 8- day than in groups 2 and 3 day. Conclusion Within 2 and 3 days，the replanted limbs of SD rats will necrose because of vein-occlusion; and 4 days later the replanted limbs can survive depending on the reflux-vein of new collateral veinlet.
Objective To investigate the results and applicationvalue of crotch-shaped vein grafts in repairing defects of the vessels with a large diameter.Methods From June 1998 to October 2003, 35 cases of vesseldefects with a large diameter were repaired with crotch-shaped vein graft (29 males and 6 females,aged 18 to 45 years with an average of 25.7 years ). The locations of defects were femoral artery in 25 cases, popliteal artery in 2 cases, femoral vein in 7 cases, and subclavian vein in 1 case. The interval between injure and operatioinwas 1-8.5 hours (4.1 hours on average).The blood flows of trouble and healthy vascular were determined with Doppler detector and compared preoperatively andpostoperatively. Results All the anastomotic stomas were patent in 35 cases. Thirty-one cases were followed up 6 weeks to 24 months (9.5 months on average), the patent rate was 100%, no case occurred vasospasm or tromboembolism; 2 cases occurred stomal leak and became hematoma, 3 cases occurred muscular necrosis, and the 5 cases achieved primary healing after secondary operation. The Doppler results showed that there was statistically significant difference in the blood flow betweenpostoperation and preoperation (Plt;0.01), but no statistically significant difference when compared the trouble vascular after operation with healthy vascular (Pgt;0.05). Conclusion The methodof crotch-shaped vein grafts is safe and effective in repairing defects of vessels with a large diameter,which is easy to draw materials and handy to operate. It has a promising value in clinical application.
This study was performed on canine femoral veins which were interpositionally implanted into the femoral arteries and the investigation was in terms of zero-stress state, compliance and hemodynamic assessment. The results revealed that the vein grafts had the similar characteristics of compliance with the normal veins. Using Doppler ultrasonography to monitor the blood flow velocity through the vein grafts, the hemodynamic parameters such as pulsatility index (PI) and blood flow volume were evaluated consecutively within one month after the operations .No significant differences were found between these parameters at different time points. It was suggested that autogenous vein graft had an adaptive course when operating in an arterial hemodynamic circumstances and It’s mechanical changes did not bear upon the hemodynamics through the vein graft.
The experiment was earied out on the a boomen of the whiterats. The epigastric vein wasarterialized by means of anastomcois with the femoral artery, lateral thoracic vein was reserved as aefferent vessel. The changes of hemorheology were mesured after arterialization, and were comparedwith the changes in the normal A-V skin flaps. The levels of platelet, aggreation, blood viscosityand plasma fibrinogen in arterialized vein flape were signmeantly higher than that in A-V flaps. ASa r...
Objective To investigate the effect and mechanism of epigallocatechin-3-gallate (EGCG) on restenosis of the vein graft. Methods Totally 90 Sprague-Dawley rats were randomly divided a the control group, a vein graft group and an EGCG+vein graft group. At week 1, 2 and 4, the intimal and tunica thickness of the venous graft wall was evaluated by hematoxylin-eosin staining, and the expression of Ki-67 was assessed by immunohistochemistry analysis, and then the expression of hairy and enhancer of split-1 (HES1) was measured by Western blot assay. Results At week 2, the intimal thickness (46.76±4.89 μmvs. 8.93±0.82 μm, 46.76±4.89 μmvs. 34.24±3.57 μm), tunica thickness (47.28±4.37vs. 16.33±1.52 μm, 47.28±4.37vs. 36.27±3.29 μm), positive cell rate of Ki-67 (21.59%±2.29%vs. 1.12%±0.22%, 21.59%±2.29%vs. 15.38%±1.30%), expression of HES1 respectively increased in the experimental group than those in the control group and the EGCG+vein graft group (P<0.05, respectively). At week 4, the intimal thickness (66.38±6.23 μmvs. 8.29±0.79 μm, 66.38±6.23 μmvs. 48.39±4.23 μm), tunica thickness (63.27±6.18 μmvs. 15.29±1.49 μm, 63.27±6.18 μmvs. 44.63±4.49 μm), positive cell rate of Ki-67 (33.19%±3.03%vs. 1.09%±0.19%, 33.19%±3.03%vs. 24.37%±2.73%), expression of HES1 increased in the experimental group than those in the control group and EGCG+vein graft group (P<0.05, respectively). Conclusion EGCG may inhibite restenosis of vein graft by inhibiting Notch signal pathway.
Objective To study the changes of endothelin (ET) and nitric oxide (NO) in the local site of vein transfer with delayed breaking pedicle and the relation with vasospasm and vein transfer in rabbits. MethodsThe ET concentration of blood was determined with the radioimmunoassay method. The plasma NO-2,NO-3 levels in the local site of vein transfer with delayed breaking pedicle, which reflected NO levels indirectly, were detected with Ultravioletvisible (UvVIS ) spectrophotometer. ResultsThe endothelin concentration of blood was increased significantly at 2, 4 hour after the operation (P＜0.01), and at 8 hour after the operation (P＜0.05). The plasma NO level was significantly decreased at 2, 4 hour after the operation (P＜0.01). But at 24 hour after the operation, the plasma NO level was increased significantly (P＜0.05). Conclusion The recovery of ET concentration of blood and the increase of plasma NO at 24 hour after the operation are the cause of the reduced incidence of vascular crisis of vein transfer with delayed breaking pedicle, and the very time point is the optimum moment for pedicle breaking.
Objective To repair defects at both ends of theblood vessels with a considerable disparity in the diameter of the both sides or with a large diameter in extremities by phleboplasty of branched and double autogenous veins. Methods Three kinds of phleboplasties——funnel-shaped, raincape-shaped and transposed Y-shaped were designed. Experiments in fresh blood vessels in vitro were completed successfully. These methods were used clinically to repair injured external iliac veins, femoral arteries and veins, and popliteal arteries and veins, to replant severed fingers and to transplant toenail flaps on thumbs by harvesting autogenous great saphenous veins,small saphenous veins and forearm veins in 36 cases, including 35 cases in emergency operation and 1 case in selective operation.The length of grafted blood vessels ranged from 1.0 cm to 15.0 cm. Results The phleboplasties of funnel-shaped could enlarge the diameter by 1.0-1.25 times inanastomotic stomas. The phleboplasty of raincape-shaped could enlarge the diameter large enough to meet the demands for various blood vessels in extremities. The phleboplasty of transposed Y-shaped could provide large vein transplants. In36 grafted veins, 35 were in patency. The blood supply in extremities was normal.ConclusionThe funnel-shaped and raincape-shaped phleboplasties of branched veins can enlarge the anastomotic stomas of grafted veins. The transposed Y-shaped phleboplasty of double femoral veins is an ideal way to repair injured primaryblood vessels with a considerable disparity in the diameter of the both sides or with a large diameter in extremities.
ObjectiveTo evaluate the effect of low power red laser illumination on the intimal proliferative response in vein graft models.MethodsAutogenous vein graft models were established in 80 rats by transplanting jugular vein to carotid artery by end to end anastomosis, and were randomized into two groups: control group (graft nonilluminated), laser illumination group (0.9 J/cm2).The grafted veins were harvested at 3,7,14 or 28 day respectively after operation. IH (intimal hyperplasia) and SMC (smooth muscle cell) proliferations were pathologically and immunohistochemically observed and analyzed by computer digitizing system. ResultsThere were no significant differences in the intimal average thickness and the areas of lumen between two groups for 3 day. Laser group was significantly lower than the control in both the intimal average thickness and the stenosis of lumen at 7 day,14 day and 28 day (P＜0.05).Immunohistochemical analysis of PCNA indicate the decreased positive cell in laser group compared with the control group (P＜0.01).ConclusionThese preliminary results demonstrate that a certain density of low power red laser illumination in vein graft inhibits SMC proliferation and neointimal hyperplasia in rat.
Objective To assess the curative effect of percutem transilluminated with negative pressured on the potaried technique on the treatment of venous ulcer in lower extremity. Methods The clinical date of 300 cases involving 300 legs with venous ulcer in lower extremity， who underwent the percutum transilluminated negative pressured potaried technique using TRIVEXTM Ⅱ potaried system or the percutum transfixion surgical treatment from October 2005 to June 2009, were analyzed. Three hundred cases were randomly divided into potaried group and transfixion group. In potaried group, there were 190 cases involving 190 legs treated with TRIVEXTM Ⅱ potaried system. In transfixion group, 110 cases involving 110 legs treated with percutum transfixion. The clinical indexes of skin infection rate and skin necrosis rate, shrinkage rate of wound area and skin depigmentation rate, ulcer healing rate and ulcer recurrence rate were calculated to assess the clinical curative effect on day 5, day 20, day 120 and day 360 after operation respectively. Results The rates of skin infection and skin necrosis were significantly decreased in potaried group compared with transfixion group on day 5 after operation (P＜0.05), the rates of shrinkage of wound area and skin depigmentation were significantly increased in potaried group compared with transfixion group on day 20 (P＜0.05). The ulcer healing rate was not significantly different between the two groups on day 120 (Pgt;0.05). Ulcer recurrence rate was remarkably lower in potaried group than that in transfixion group on day 360 (P＜0.05). Conclusion It can be concluded that percutem transilluminated with negatived pressured on the potaried technique with TRIVEXTM Ⅱ potaried system can efficiently promote the healing of venous ulcer in the lower extremity, and at the same time it has an ascendancy in lessening skin infection and skin reinjury.
The femoral veins were excised from 28 dogs and distended with pressure of 40, 80 and 120 kPa, respectively before grafted to femoral arteries. The veins were harvested at different times and Pollak sections were prepared which revealed different stains of elastin, collagen and smooth muscle in each section. The sections were led to image analysis system to computerize the relative contents of theabove components. The results were as follows: Elastin decreased significantly at 4 weeks (P lt;0.01), and was constant between 4 and 16 weeks. No statistical difference was found in 40, 80 kPa and the control group (P gt;0.05), but the elastin of 120 kPa group by the 16th week was still decreasing. Collagen of each group had no difference, but C/E increased significantly with time. Smooth muscle contents were correlated positively with time, and negatively with the pressure at 1 week, then positively with the pressure at 16th week. The changes of the above trends were the same as development of intimal hyperplasia. The contentions were the value of C/E was determined by the arterial pressure but that of 120 kPa pressure was more higher. The preimplant pressure distension was a possible significantfactor leading to excessive intimal hyperplasia of early and middle stage of autogenous vein grafts.