Swiss surgery. Supplement最新文献

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[Small-caliber polyurethane arterial prosthesis: clinical and angiomorphological follow-up of 20 patients in a prospective study]. [小口径聚氨酯动脉假体:20例患者的前瞻性临床及血管形态学随访]。

Swiss surgery. Supplement

Pub Date : 1996-01-01

B Gloor, E Wehrli, A Rotzer, D Brunner, C Wilms, J Largiadèr

The five year patency rate for femoropopliteal vein bypass grafts is around 70% according to the literature. Patency rates for synthetic grafts (eg PTFE, Dacron) range between 43 and 57%. If a vein is not available there is a new polyurethane 6 mm artery substitute on the market, that has shown in vitro promising physical characteristics and good long term results after implantation in dogs. In a prospective, randomized trial the results of the new polyurethane graft (PUR) were compared with those of a Dacron graft of the same diameter. Included in the study were 20 patients with lower limb ischemia stage Fontaine II B, III and IV, 10 in each group. Patency rates, handling of the graft and complications were analysed. During the one year follow up 7 PUR grafts had to be changed due to recurrent bypass occlusion within the first 3 months. At the end of the year there were only one PUR-bypass but 8 Dacron grafts open. 5 PUR grafts were examined histologically and no morphological reason for the occlusion, especially no myointimal hyperplasia, was found. A special regard was brought to the arterial run-off in both groups. It was confirmed to be comparable with only slightly better data for the PUR group. The exact reasons for the astonishing bad results of the PUR graft for femoropopliteal above knee bypass cannot be explained in our study. Due to the unexpected high occlusion rate the study was stopped earlier then planned.

根据文献，股腘静脉旁路移植术的5年通畅率约为70%。合成移植物(如聚四氟乙烯，涤纶)的通畅率在43%至57%之间。如果没有静脉，市场上有一种新的聚氨酯6毫米动脉替代品，在植入狗体内后显示出体外有希望的物理特性和良好的长期效果。在一项前瞻性的随机试验中，将新型聚氨酯接枝(PUR)与相同直径的涤纶接枝进行了比较。选取下肢缺血期Fontaine II、B、III、IV期患者20例，每组10例。分析了通畅率、移植物处理及并发症。在一年的随访中，由于前3个月内再次发生旁路闭塞，有7例PUR移植物不得不更换。到年底，只有一个pur旁路，但8个涤纶移植物开放。对5例PUR移植物进行组织学检查，未发现形态学原因，特别是未发现肌内膜增生。在两组中，对动脉径流都给予了特别的关注。经证实，它与PUR组的数据仅略好一些。在我们的研究中无法解释PUR移植物在膝上股腘动脉旁路手术中令人震惊的不良结果的确切原因。由于意外的高闭塞率，研究比计划提前停止。

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引用次数: 0

[Self-expanding endoluminal vascular prosthesis: experimental basis and in-vivo evaluation]. 自扩张腔内血管假体:实验基础与体内评价。

Swiss surgery. Supplement

Pub Date : 1996-01-01

B Marty, T Marty, L K von Segesser, M Turina

The present study investigates the physical properties and the in vivo application of in vivo of a self-expandable stent (Wallstent) with an incorporated sealant of microporous polyurethane. Measurements of diameter and length as a function axial load featured the data for the calculation for radial pressure. Porosity control was assessed in comparison to non gelatin-sealed knitted Dacron. 11 stents on a 11.5F catheter were inserted in the aorta of three minipigs and evaluated by pressure measurement and angiography. The coverage of the stent causes an increase of 0.05-0.1 bar of radial pressure. The graph received by calculations demonstrates the corresponding pressure for every given diameter of the stents. Porosity is similar to the Dacron graft. The patency-rate is 100%. Characteristics of this covered stents meet requirements of an endovascular prostheses. Exclusion of fistulas and small aneurysms seems to be possible.

本研究研究了微孔聚氨酯密封胶自膨胀支架(Wallstent)的物理性能及其在体内的应用。直径和长度作为轴向载荷的函数的测量为计算径向压力提供了数据。与非明胶密封的针织涤纶相比，评估孔隙度控制。将11个支架置于11.5F的导管上，通过压力测量和血管造影进行评估。支架的覆盖使径向压力增加0.05-0.1 bar。计算得到的曲线图显示了每个给定支架直径对应的压力。孔隙度与涤纶接枝相似。专利率为100%。这种覆盖支架的特性符合血管内假体的要求。排除瘘管和小动脉瘤似乎是可能的。

引用次数: 0

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