Evaluation of peritoneal tube grafts in the inferior vena cava of the pig

Abstract

A tube graft 2.5 or 5 cm long, was constructed from the peritoneum of the anterior abdominal wall of 12 pigs. It was anastomosed end-to-end as an interposition graft in the infrarenal vena cava. The observation period was 4 months. Three of the six short grafts were venographically patent at 2 weeks, while all the long grafts were occluded. After 4 months two short grafts had recanalized, giving a patency rate of five out of six short grafts. No long grafts recanalized. In three of the patent specimens no clear tissue changes were found with light microscopy, while in the others changes of inflammation and fibrosis were noted. Scanning electron microscopy revealed good 'endothelialization' in two specimens, and partial 'endothelialization' in the others. No dilatation or severe stenosis of the patent grafts was seen. The occluded grafts remained only as a fibrous strand with sutures.

Treatment of major vein injury with the hemostatic fleece TachoSil by interposing a peritoneal patch to avoid vein thrombosis: A feasibility study in pigs

“…[9] Vein wall defects longer than 2.5 cm may not be amenable to this repair technique. [10] Although a minimum gluing zone of 0 to 2 mm provided successful hemostasis in four of our five experimental animals, a broader zone all around the patch is necessary for safe hemostasis. An insufficient gluing zone may be present wherever a squirt of blood appears on removal of the sponge used for compression, but the absence of a squirt of blood after the compression period does not exclude the presence of a narrow gluing zone.…”

“…A previous study has shown that a peritoneal tube may successfully replace a 2.5 cm segment of the vena cava, but longer tubes will undergo thrombotic occlusion. [10] Vein wall defects longer than 2.5 cm may therefore not be amenable to this repair technique.…”

“…[4–8] TachoSil with a peritoneal patch interposed to prevent vein thrombosis has been reported as a method to obtain hemostasis in vein laceration, but documentation is scarce. [910] In this investigation, we evaluated the feasibility of using a peritoneal patch and TachoSil to repair partial wall defects in the vena cava of pigs.…”

The use of biological grafts for reconstruction of the inferior vena cava is a safe and valid alternative: results in 32 patients in a single institution

“…APF is readily available and the harvesting and fashioning of the graft can be easily performed in a short time. Experimental data have demonstrated that the inner peritoneal mesothelial surface has a low thrombogenic potential and induces rapid endothelialization …”

Beneficial use of the round ligament as a patch graft for vena cava reconstruction

“…It has been shown that there are mesothelial linings on the inner side of its closed lumen 14. Ribbe et al15 reported that such a mesothelial lining was antithrombogenic and that it also promoted endothelialization. These characteristics of the opened round ligament could be advantageous for its use as a vascular patch graft, including its use in the low‐pressure venous system.…”