Summary
Scanning electron microscopy was used to diagnose incidents of trauma and the pattern of healing following surgical implantation of microporous blood vessel substitutes. Vascular reconstruction procedures using autogenous or synthetic prosthetic material inflict damage to the adjacent tissues as well as the prosthesis. This affects the thrombotic behavior and healing pattern of the area. The prognosis for long-term success are, as a consequence, directly influenced. Various vessel-occluding devices were evaluated in canine models with respect to their ability to damage blood vessels at the clamped site. The impact of suture needles on tissues and prosthetic materials was also considered. Of the various vessel-clamping devices which are commercially available, those which have elastomeric shields on the clamping components were found to be most satisfactory. The development of less traumatical surgical devices is discussed with the aim of further reducing surgical trauma.
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Malone JM, Moore WS, Goldstone J (1977) Life expectancy following aortofemoral arterial grafting. Surgery 81:551
Myers KA, King RB, Scott DF, et al (1978) The effect of smoking on the late patency of arterial reconstructions in the legs. Br J Surg 86:243
Veith FJ, Mass CM, Fell SC, et al (1978) Comparison of expanded polytetrafluoroethylene and autologous saphenous vein grafts in high risk arterial. Surg Syn Obstat 147:749
Haimov H, Giron F, Jacobson JH (1978) The expanded polytetrafluoroethylene graft: three years' experience with 362 grafts. Arch Surg 114:673
Courbier R, Jausseran JM, Reggi M, Cliche G (1979) Les prothèses artérielles en polytetrafluoroethylene—Premiers résultats cliniques. J Mal Vasc 4:151
Campbell CD, Brooks DM, Webster MW, Bahson HT (1976) The use of expanded microporous polytetrafluoroethylene for limb Salvage: a preliminary report. Surgery 79:485
Campbell CD, Brooks DH, Webster MW, et al (1976) Aneurysm formation in expanded polytetrafluoroethylene prostheses. Surgery 79:491
Guidoin R, Martin L, Levaillant PA, et al (1978) Endothelial lesions associated with vascular clamping surface micropathology by scanning electron microscopy. Biomat Med Dev Art Org 6:179
Guidoin R, Levaillant PA, Marois M, et al (1980) Les prothèses en polyethylene téréphthalate (Dacron) comme substituts artériels: évaluation des greffes commerciales comme substitut de l'aorte abdominale de chiens. J Mal Vasc 5:3
McCaughan JJ Jr, Young JM (1970) Intra-arterial occlusion in vascular surgery. Ann Surg 171:695
Guidoin R, Paré G, Gosselin C, et al (1979) Etude par microscopie électronique à balayage des sutures utilisées pour l'implantation d'une prothèse vasculaire synthétique. Vie Méd Can Fr 8:543
Roy J, Guidoin R, Cardou A, et al (1980) Cardiovascular sutures as assessed by scanning electron microscopy. Scan Elect Microsc 3:203
Rubio PA, Farrell EM (1979) A new needleholder for microvascular surgery. Cardiovasc Dis (Bull Tex Heart Inst) 6:76
Acland RD (1978) A flat-bodied needle for microvascular surgery. Plast Reconstr Surg 65:793
Guidoin R, King M, Blais P, et al (1981) A biological and structural evaluation of retrieved Dacron arterial prostheses. NBS Report 601:29
Conway PF, Simmens SC, Charlesworth D (1979) A study of arterial prostheses by scanning electron microscopy. Br J Surg 66:262
De Palma RG, Chidi CC, Sternfeld WC, Koletsky S (1977) Pathogenesis and prevention of trauma-provoked atheromas. Surgery 82:429
Mansfield PB, Hall DG, DiBenedetto G, et al (1978) The care of vascular endothelium in pediatric surgery. Ann Surg 188:216
Duguid IB (1948) Thrombosis as a factor in the pathogenesis of aortic atherosclerosis. J Pathol 60:57
Spaet TH, Gagnon G (1969) Vascular endothelial damage and thrombosis. Adv Cardiol 4:47
Moseley HS, Connell RS, Krippaehne WW (1974) Healing in the canine aorta after endarterectomy. A SEM study. Ann Surg 180:329
Schwartz SM, Stemerman MB, Benditt EP (1975) The aortic intima. II. Repair of the aortic liming after mechanical denudation. Am J Pathol 81:15
Spaet TH, Stemerman MB, Veith FJ, Lejnieks I (1975) Intimal injury and regrowth in the rabbit aorta. Medial smooth muscle cells as a source of neointima. Circ Res 36:58
Helin P, Lorenzen I, Garbarsch C, Matthiessen ME (1971) Repair in arterial issue: morphological and biochemical changes in rabbit aorta after a single dilatation injury. Circ Res 29:542
Webster WS, Bishop SP, Geer JC (1974) Experimental aortic intimal thickening—II. Endothelialization and permeability. Am J Pathol 76:265
Reidy MA, Bowyer DE (1977) SEM of aortic endothelium following injury by endotoxin and during subsequent repair. Prog Biochem Pharmacol 14:175
Reidy MA, Bowyer DE (1978) Distortion of endothelial repair. The effect of hypercholesterolemia on regeneration of aortic endothelium following injury by endotoxin. A SEM study. Atherosclerosis 29:459
Hickman GA, Mortensen JD (1962) A comparative evaluation of vascular clamps. J Thorac Cardiovasc Surg 44:561
Brown L (1961) A vascular clamp utilizing sponge rubber. Arch Surg 83:177
Fogarty TJ, Raible DA, Krippaehne WW (1966) A new vascular clamp. Am J Surg 112:967
Berlin RB (1978) Vascular clamping: a new concept with manometric studies comparing available instruments with a novel design. Vasc Surg 12:108
Dunn DC (1973) The use of the arterial tourniquet in surgical practice. Br J Surg 60:594
Dunn DC (1977) An implatable occluder for clinical use. J Cardiovasc Surg 18:123
Bernhard VM, Boren CH, Towne JB (1980) Pneumatic tourniquet as a substitute for vascular clamps in distal bypass surgery. Surgery 87:709
Edwards WH, Mulherin JL (1979) An internal vessel occluder for distal limbs by-pass. Ann Thorac Surg 27:472
Wilgis EFS (1971) Observations on the effect of tourniquet ischemia. J Bone J Surg 53:1343
Mullick S (1978) The tourniquet in operations upon the extremities. Surg Gynecol Obstet 146:821
Osgood CP, Dujovny M, Faille, et al (1976) Early scanning electron microscopic evaluation of microvascular maneuvers. Angiology 27:96
Mohr G, Ouaknine GE, Hardy J (1980) Etude de la microchirurgie vasculaire expérimentale à l'aide du microscope électronique à balayage. Union Med Can 109:1130
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Supported in part by grants from W. L. Gore and associates, the Quebec Heart Foundation, and the Dept. of National Health and Welfare
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Guidoin, R., Doyon, B., Blais, P. et al. Effects of traumatic manipulations on grafts, sutures, and host arteries during vascular surgery procedures. Res. Exp. Med. 179, 1–21 (1981). https://doi.org/10.1007/BF01852121
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DOI: https://doi.org/10.1007/BF01852121