Management of Major Arterial Injuries of Limbs: A Study of 166 Cases

Yupu, Lu; Huang, Ye; Rensheng, Z. Li L.; Kaijun, S.; Ping, M.; Xiao-Chao, Chu

doi:10.1177/096721099300100503

Cited by 10 publications

References 7 publications

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Results of autogenous vein grafts in repair of major arterial injuries to the upper and lower extremities with reference to wall shear stress

Zhao¹,

Huang²,

Li³

et al. 2011

Int J Angiol

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This investigation was designed to retrospectively review the results of autogenous vein grafts used for extremity arterial injuries. The mean value of the wall shear stress during a cardiac cycle was calculated by blood flow waveform analysis. The records of 103 patients with 106 arterial injuries repaired with autogenous vein grafts were reviewed. One hundred and two (96.2%) were patent in the early postoperative period. The mean length of follow-up was 6 years and 5 months (range 1-23 years). Fifty-one patients were followed beyond 1 year. Of the 51 patients followed for more than 1 year, 49 (96.1%) patients had excellent peripheral circulation, however, two patients complained of mild ischemic pain. The patency of 26 of the 28 vein grafts was revealed by Doppler ultrasonic imaging studies. The excellent results obtained in this investigation reinforced our preference for using autogenous vein grafts for repair of extremity arterial injuries. The upper extremity grafts had a better outcome than those of the lower extremity; this was associated with a higher value of the wall shear stress. We propose that wall shear stress be measured for follow-up studies of vascular grafts in extremity arterial injuries and that hemodynamic factors should be considered during arterial reconstructive procedures.

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Results of autogenous vein grafts in repair of major arterial injuries to the upper and lower extremities with reference to wall shear stress

Zhao¹,

Huang²,

Li³

et al. 2011

Int J Angiol

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Effects of Axial Stretch on Cell Proliferation and Intimal Thickness in Arteries in Organ Culture

et al. 2010

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Intimal hyperplasia (IH) remains the major cause of intermediate and long-term failure of vascular grafts and endovascular interventions. Arteries are subjected to a significant longitudinal stress in addition to the shear stress and tensile stress from the blood flow. The aim of this study was to determine the effect of axial stretch on cell proliferation and IH in arteries. Porcine carotid arteries, intact or endothelial cell (EC) denudated, were maintained ex vivo at different stretch ratios (1.3, 1.5, and 1.8) and flow rates (16 or 160 mL/min) while remaining at physiologic pressure for 7 days. The viability of the arteries was verified with norepinephrine, carbachol, and sodium nitroprusside stimulations, and the cell proliferation was detected using bromodeoxyuridine labeling and immunostaining. Our results showed that the axial stretch ratio did not significantly affect intimal thickness and cell proliferation in normal arteries. However, axial stretch increased the neointimal thickness in EC denudated arteries cultured under low flow conditions. The cell proliferation increased significantly in the intima and inner half of the media of the EC denudated arteries under normal or elevated axial stretch in comparison to intact arteries at the same stretch ratio. These results demonstrated that axial stretch with EC denudation and low flow increases neointimal formation and cell proliferation in the arteries.

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Upper Extremity Vascular Trauma

Griffen¹,

Frykberg²

2008

Current Therapy of Trauma and Surgical Critical Care

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Management of Major Arterial Injuries of Limbs: A Study of 166 Cases

Cited by 10 publications

References 7 publications

Results of autogenous vein grafts in repair of major arterial injuries to the upper and lower extremities with reference to wall shear stress

Results of autogenous vein grafts in repair of major arterial injuries to the upper and lower extremities with reference to wall shear stress

Effects of Axial Stretch on Cell Proliferation and Intimal Thickness in Arteries in Organ Culture

Upper Extremity Vascular Trauma

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