Mark F. Fillinger, MD, Emanuel R. Reinitz, MD, Robert A

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Presentation transcript:

Graft geometry and venous intimal-medial hyperplasia in arteriovenous loop grafts Mark F. Fillinger, MD, Emanuel R. Reinitz, MD, Robert A. Schwartz, MD, Dennis E. Resetarits, MD, Andrew M. Paskanik, David Bruch, MS, Carl E. Bredenberg, MD Journal of Vascular Surgery Volume 11, Issue 4, Pages 556-566 (April 1990) DOI: 10.1016/0741-5214(90)90302-Q Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Implant configuration. One side is always a 6 mm untapered graft. Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Subdivision of vessels for histology. Note the location numbers for orientation in the text and other figures. Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Doppler spectral tracings 12 weeks after implantation. 1, 2, and 4 refer to location numbers (Fig. 2). A specimens are from a 4 to 7 mm taper graft, B specimens are from a 6 mm untapered graft in the same animal as A, and C specimens are from a 7 to 4 mm taper graft. Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Color Doppler images of tissue vibration surrounding the superior vein (including locations 1 through 3) at 12 weeks after implantation. A, vein from a 4 to 7 mm taper graft; B, vein from a 6 mm untapered graft in the same animal as A; C, vein from a 7 to 4 mm taper graft; D, vein from a 6 mm untapered graft in the same animal as C. Grafts are at the top right and flow is from right to left in each picture. Vibration signals obscure portions of the vein near the graft. Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Mean pessure values (mm Hg) for the three graft configurations. Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Histologic specimen from a 7 to 4 mm taper graft configuration at venous location 2, demonstrating severe intimal-medial hyperplasia three months after implantation. I-M, Intima-media; Ad, adventitia. (Modified iron-hematoxylin stain; original magnification × 200.) Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Venous intimal-medial thickness in 4 to 7 mm taper grafts (F1-F5) and paired 6 mm untapered grafts (Uf1-Uf5), mean ± SE. Cntrl, Normal control vein; numbers 1 through 5 refer to locations 1 through 5 (see Fig. 2). Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 8 Venous intimal-medial thickness in 7 to 4 mm taper grafts (S1-S5) and paired 6 mm untapered grafts (Us1-Us5), mean ± SE. Cntrl, Normal control vein; numbers 1 through 5 refer to locations 1 through 5 (see Fig. 2). Journal of Vascular Surgery 1990 11, 556-566DOI: (10.1016/0741-5214(90)90302-Q) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions