Document Detail

Experimental replacement of the inferior vena cava: factors affecting patency.
MedLine Citation:
PMID:  6729703     Owner:  NLM     Status:  MEDLINE    
To evaluate factors influencing graft patency in the venous system, we replaced the inferior vena cava (IVC) in 50 dogs. Expanded polytetrafluoroethylene ( ePTFE ) grafts with external support were implanted into 32 animals while autogenous, spiral jugular vein grafts were used to replace the IVC in 18 dogs. 111In-labeled autologous platelets and 125I-labeled canine fibrinogen were utilized to evaluate early thrombus formation. A distal arteriovenous (AV) fistula significantly (P less than 0.05) decreased both platelet and fibrin deposition on ePTFE grafts 3 hours following implantation. Patency rate of 12 ePTFE grafts with a temporary AV fistula was higher (75%) than that of grafts without fistula (25%) at 3 months (P less than 0.05). Spiral vein grafts with fistula showed 91% patency at 3 months; without fistula patency was only 67%. Venograms confirmed patency in five grafts followed up to 6 months. Antiplatelet therapy resulted in 100% patency in ePTFE and vein grafts during its administration, and vein grafts maintained patency after discontinuation of antiplatelet treatment. Spiral vein grafts showed no decrease in cross-sectional area at 3 months, while the cross-sectional area of ePTFE grafts decreased significantly (59%). Distal AV fistula decreases platelet and fibrin deposition leading to early occlusion in ePTFE grafts and produces excellent patency in spiral vein grafts. Antiplatelet therapy appears to further improve patency.
P Gloviczki; L H Hollier; M K Dewanjee; V F Trastek; E A Hoffman; M P Kaye
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  95     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1984 Jun 
Date Detail:
Created Date:  1984-06-26     Completed Date:  1984-06-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  657-66     Citation Subset:  AIM; IM    
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MeSH Terms
Arteriovenous Shunt, Surgical
Blood Vessel Prosthesis*
Heparin / administration & dosage
Ibuprofen / administration & dosage
Jugular Veins / transplantation*
Postoperative Complications
Regional Blood Flow
Thrombosis / etiology
Vena Cava, Inferior / surgery*
Reg. No./Substance:
15687-27-1/Ibuprofen; 9002-84-0/Polytetrafluoroethylene; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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