미세혈관문합 후 혈관내벽의 치유과정에 관한 실험적 연구
Experimental studies about healing process of blood vessels following microvascular annastomoses
황우익, 홍경천,
소속 상세정보
황우익 ( ) - 고려대학교
홍경천 ( ) - 고려대학교
KMID : 0360119940160040397
Abstract
Microvascular surgery has been widely used in the clinical field of replantation and reconstructive surgery. Since the last 20 years, microsurgical techniques and instruments have been rapidly developed and the success rate is remarkably
increased.
But
thrombotic occlusion of vessels remains the major reason for clinical failure. The change of vessel wall in the most important factor in thrombus formation. If we can reduce the traumatic changes in the vessel walls during surgery, the success
rate
can
be markedly increased.
For this study, femoral arteries and veins of 36 Sprague-Dawley rats with average weights of 300gm were used. The author observed the histological changes and healing process in the anastomostic site after 1 hour, 24 hours, 1, 2, 3 and 4 weeks
under
light microscopy and scanning electron microscopy.
@ES The results were as follows :
@EN 1. The patency rate was 100% in femoral arteries and 85% in femoral vein.
2. At the early stages after microvascular anastomosis the loss of endothelial cell in the vessel walls was observed in the wide area including anastomotic site. In scanning electron microscopic finding, the anastomotic site was covered with
much
fibrin, many red blood cells and some platelets.
3. At lst week, new endothelial cells were formed toward anastomostic site and at 3rd week, the anastomotic site was completely covered by new endothelial cells. At 4th week, the complete endothelialization over the threads was observed.
4. The media necrosis extended from the anastomotic site toward the end of the specimen. At later stages, the extent of media necrosis was markedly decreased. But the media necrosis of anastomotic site was not regenerated till 5th week.
5. Intimal hyperplasia appeared at Ist week and increased till 4th week. The layer consisted of endothelium in the most luminal layers and smooth muscle in the deeper layers. But in veins, the response was less pronounced than in arteries.
6. Foreign body granuloma remained during 4 weeks and aneurysm was observed at 3rd week in artery. In aneurysmal wall, media necrosis, loss of elastic lamina and intimal hyperplasia were seen.
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