J.Jpn. Surg. Soc.. 61(8): 1101-1125, 1960
Original article
STUDY ON GRAFT OF VASCULAR PROSTHESIS INTO MIDDLE AND SMALL VESSELS
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The 2nd Surgical Department, Kyoto Prefectural Medical School (Director: Prof. Kenji KAWAMURA) Yoshio ARAKAWA |
1) The rate of patency for replacing middle vessels (diameter 8.5-5.5 mm) were 43％ for silk, 30％ for nylon and 55％ for dacron while for replacing small vessels (diameter 4.3-2.5 mm) with silk and nylon prosthesis, the results were unsatisfactory. However, 1 case out of 4 cases of dacron, 2 cases out of 3 cases of orlon on the short term were satisfactory though it was contrary on the long term.
2) With regard to endothelization of the prosthesis, increase of intima of anastomotic site plays an important role, and it is supposed that formation of fibrous lining through interstices of weave of the graft plays secondary part.
3) Goodness of suture technique is extremely important factor which influences the results of the graft.
4) The thickness of fibrin lining of prosthesis has on influence upon occlusion of small vessels. From this viewpoint, it is preferble to use materials which have less tissue reaction than what have been used by the author in case of small vessels.
5) The porosity of prosthesis is useful for endothelization and for combination with a host tissue, however, when it is too porous, a good result cannot be expected due to haematoma and hemorrage.
6) The diameter of prosthesis is considered suitable to be one and half times as long as that of the host artery in order to avoid strictures of anastomotic part in case of grafting the small vessel.
7) As a suture technique, in case of grafting small vessels, it is considered adequate to do continuous over and over suture after everting knot-sutures had been placed at two corners.
8) On the basis of those experimental findings, favorable results have been obtained clinically by inserting teflon climped tubes into the defected parts of the femoral artery of 5.5 mm in diameter and brachial artery of 4.5 mm in diameter.
(Author's abstract)
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