H. Itoh et al., LATE GRAFT FAILURE OF AUTOLOGOUS VEIN GRAFTS FOR ARTERIAL OCCLUSIVE DISEASE - CLINICAL AND EXPERIMENTAL STUDIES, SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY, 25(4), 1995, pp. 293-298
Late graft failure following arterial reconstructive surgery, especial
ly after infrainguinal reconstruction, remains a major concern for vas
cular surgeons. To more effectively predict the outcome of reconstruct
ed arteries, we herein propose an intraoperative Bow waveform analysis
which correlates well with the long-term patency rate of grafts. Acco
rding to this flow waveform analysis, late graft failure was occasiona
lly seen in grafts with type II waveforms when poor distal runoff vess
els had been shown by the preoperative arteriogram. Next, to investiga
te which events occurring in autologous vein grafts under abnormal hem
odynamics may contribute to late graft failure, a distal poor-runoff m
odel was made in the canine femoral artery. In this review, we present
the results of our investigation on autologous vein grafts using this
poor-runoff model. We also relate our recent findings on the function
of regenerated endothelium in autologous vein grafts.