頭頸部領域における血管移植に関する実験的研究

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概要

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• This paper concerns with a comparison of the suitability of different type of grafts and suture methods for the transplantation of the carotid artery in dogs and moreover, of the influence which X-ray irradiation exerted on arteriolization of these implanted grafts.The histopathologic fates of the grafts were studied in the original method of Hautchen-preparation in addition to that of routine transverse section.The results were summarized as follows;1) The autologous vein grafts were inserted with suturing apparatus gave well functional results in end-to-end anastomosis. The synthetic grafts functioned satisfactorily in only use of patch-angioplasty.2) Microscopic examination showed fibrous thickening of the vessel wall with brocken elastic fibers in the autologous vein grafts.In the synthetic grafts, fibrous layers were noticed covering both their internal and external surfaces. It may be considered that the endothelization has originated from the intima of the host artery and this growth appeared to be independent of the sub-endothelial healing processes.3) In the 2500R. fractionally irradiated group, there were no remarkable changes either grossly or microscopically. But in the 4000R. and 7000R. fractionally irradiated group, the patency rate for the grafts showed less good results because of necrosis, infection and thrombosis of the grafts.This tendency was remarkable in the synthetic graftings, and more noticeable in the pre-operatively irradiated group than the post-operatively group.4) As histopathologic changes induced by X-ray irradiation, in the autologous vein grafts, there were edematously thickened connective tissue of the vessel wall with marked fraying of the elastic fibers, cell infiltration and increased amounts of acid-mucopolysaccharide, especially in the intima and the media. In the synthetic grafts, edematous thickening of fibrous layers was dominant and marked round cell infiltration around the mesh layer were often observed.No changes, however, attributable to the irradiation could be demonstrated with certainty in the endothelial cell itself of each group.5) It is suggested that the autologous vein grafts are preferable to the synthetic materials as substitute for smaller arteries and the “Sandwich-method” seems more successful and suitable when the vascular transplantation has need of combination with the irradiation.

• 社団法人 日本耳鼻咽喉科学会の論文

著者

• 大山 勝

  三重県立大学医学部耳鼻咽喉科教室

• 大山 勝

  三重県立大学医学部耳鼻咽喉科学教室

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