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21.
N. Blanchemain S. Haulon B. Martel M. Traisnel M. Morcellet H.F. Hildebrand 《European journal of vascular and endovascular surgery》2005,29(6):628-632
PURPOSE: Cyclodextrins (CDs) are torus shaped cyclic oligosaccharides with a hydrophobic internal cavity and a hydrophilic external surface. We performed and analysed an antibiotic binding on Dacron (polyethyleneterephtalate, PET) vascular grafts, previously coated with CDs based polymers. METHODS: The CDs coating process was based on the pad-dry-cure method patented in our laboratory. The Dacron prostheses were immersed into a solution containing a polycarboxylic acid, a cyclodextrin and a catalyst, and placed into a thermofixation oven before impregnation with an antibiotic solution (Vancomycin). Biocompatibility tests were performed with L132 human epithelial cells. The antibiotic release in an aqueous medium was assessed by batch type experiments using UV spectroscopy. RESULTS: Viability tests confirmed that the CDs polymers coating the Dacron fibers were not toxic towards L132 cell. Cell proliferation was similar on coated and uncoated grafts. A linear release of Vancomycin was observed over 50 days. CONCLUSION: Our results demonstrate the feasibility of coating CDs onto vascular Dacron grafts. Biological tests show no toxicity of the different cyclodextrins coated. A linear release of antibiotics was depicted over 50 days, demonstrating that cyclodextrin grafting was an efficient drug delivery system. 相似文献
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The Use of Stent Grafts for the Treatment of Aneurysms and Dissections of the Thoracic Aorta: A Single Centre Experience 总被引:5,自引:0,他引:5
P. Matravers R. Morgan A. Belli 《European journal of vascular and endovascular surgery》2003,26(6):587-595
OBJECTIVE: To review the results of stent graft treatment for diseases of the thoracic aorta. DESIGN: A retrospective study of the results of thoracic stent graft procedures in a single centre. METHODS: The results of 30 procedures performed in 24 patients were analysed. Eleven patients had aneurysmal dilatation of the descending thoracic aorta (>5.5 cm), nine patients had complicated type B dissection, three had penetrating ulcers and one had a traumatic pseudoaneurysm. Imaging follow-up consisted of CT scans performed at one, three, six and 12 months following the procedure and annually thereafter. RESULTS: One technical failure occurred due to a ruptured external iliac artery. There were no other immediate failures. The primary technical success rate was 83%. The 30-day procedural and patient mortality rates were 7 and 8%, respectively. No neurological complications occurred. Seven patients had the subclavian artery covered without complications. Secondary intervention was required in 21%. During the follow-up period (mean 11 months, range 1-48 months.) there were five deaths, two of which were related to stent graft infection. CONCLUSION: Thoracic stent grafts offer a realistic alternative to surgery. 相似文献
26.
Hiroko Sasahara Susumu Sueyoshi Toshiaki Tanaka Hiromasa Fujita Kazuo Shirouzu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(5):231-239
Objective: The purpose of this experimental study was to investigate whether aortic stent grafting can be applied to the treatment of
an esophageal cancer involving the thoracic aorta. Methods: The canine thoracic aorta was partially resected without aorta being clamped after emplacement of an endovascular stent graft.
Study I; The aortic whole layer of 1 cm in length and 1/4 of the circumference was resected and was covered by a free fascia
patch of the abdominal rectal muscle immediately after stent graft placement. Study II; The aortic adventitia and the outer
half of the media of the same size was resected on day 3, 7,14, 21, and on day 28, after the stent graft placement. The resected
portion was covered by the free fascia patch in half experimental dogs, and was uncovered in the others. Study III; The aortic
adventitia and the outer half of the media of 1 cm in length and 1/2 of the circumference was resected and was uncovered on
day 7 after stent graft placement. Histological examinations were performed on day 28 and at one year after aortic resection.
Results: The aortic wall could be resected in all cases with no complication, except in resection of 1/2 the circumference where the
aorta had become narrow. There was no difference in healing of the resected portion of the aorta between with and without
fascia covering. Conclusion: An aortic endovascular stent graft could be applied to surgery for an esophageal cancer involving the aorta. 相似文献
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Intimal hyperplasia and hemodynamic factors in arterial bypass and arteriovenous grafts: a review 总被引:3,自引:0,他引:3
Stenosis at the graft–vein junction caused by intimal hyperplasia (IH) is the major cause of failure of vascular access grafts used for hemodialysis. There is a strong relationship between hemodynamic factors and formation of IH. The hemodynamic pattern and the location of IH are different in arterial bypass grafts (ABGs) compared with arteriovenous grafts (AVGs). In an ABG, end-to-side anastomosis of the expanded polytetrafluoroethylene graft and artery produces hemodynamic changes around the junction. IH develops at the arterial floor and the toe and heel of the distal anastomosis. Low shear stress and oscillating shear forces at the arterial floor and the heel plus a high wall sheer stress (WSS) gradient at the toe probably promote IH development. Compliance mismatch between the graft and artery causes turbulence that may contribute to IH formation. The blood flow rate in AVGs is 5–10 times greater than that in ABGs. High flow causes turbulence that injures endothelial cells and eventually results in IH. The peak WSS in AVGs is about 6N/m2, much higher than that in ABGs. Excessively high WSS may effect IH formation in AVGs. Several venous cuff or patch anastomotic designs have been used in attempts to regulate hemodynamic factors in grafts. In ABGs, these designs appear to help decrease IH formation. In AVGs, however, they generally have not improved patency rates. In a high-flow system such as an AVG, more drastic changes in anastomotic design may be required. 相似文献
29.
Ichiya Yamazaki MD PhD Norihisa Karube MD PhD Tamitaro Soma MD Yasuharu Noishiki MD PhD Yukio Ichikawa MD PhD 《Journal of artificial organs》2005,8(1):67-70
The aim of this study was to test the safety and efficacy of fragmented autologous adipose tissue (FAT) grafts for revascularization in aortoiliac occlusive disease. Twenty-seven patients with atherosclerotic aortoiliac occlusive disease underwent surgical treatment using FAT grafts. A piece of adipose connective tissue was obtained from the operative wound, cut into small pieces, and pressed into the wall of a fabric vascular prosthesis. Cumulative primary patency rates were 92% at 1 year, 92% at 3 years, and 86% at 6 years. Cumulative secondary patency rates were 96%, 96%, and 90% for the same intervals. In this clinical study, the FAT grafts demonstrated good long-term patency rates and no particular problems. This is the first clinical report of long-term outcomes using FAT grafts for aortofemoral or aortoiliac bypasses. FAT grafts are thus safe for revascularization in aortoiliac occlusive disease. 相似文献
30.
M. A. Helal K. C. Watts A. E. Marble 《Medical & biological engineering & computing》1993,31(6):562-568
A hydrodynamic model for the part of the human arterial network below the renal arteries has been constructed using specially
fabricated distensible tubes and a pulsatile pump to simulate an aortoiliac bypass. The experiments and the computer model
indicated that no ‘steal’ occurred due to the insertion of the bypass graft. Also, the results showed that the length of the
stenosis had a non-systematic apparent effect on the physiological significance of the obstruction and that the kinetic power
represented only a small percentage of the total power. The total power efficiency of the bypass graft was unaffected by its
elastic properties. The experimental investigation also indicated that the pressure drop across the stenosis was considerably
larger than the drop calculated using the Poiseuille flow relationship when the stenosis was severe. Therefore, a critical
arterial stenosis value cannot be defined as an obstruction of a constant percentage reduction of luminal area. It varies
directly with the effective cross-sectional area and inversely with the flow rate. The value of angiography in assessing the
functional significance of any arterial stenosis is there-fore limited. A better method for evaluation requires quantitative
measurements of local blood pressure and blood flow, not only at rest, but also under conditions creating augmented flows
due to exercise. 相似文献