Vein Graft for Repair of Peripheral Nerve Gap

Abstract

Ten millimeter gaps in sciatic nerves of rats were repaired by vein grafting (n = 30) and by nerve grafting (n = 30). Electrophysiologic evaluation demonstrated that the nerve-graft group had a significantly higher percentage of re-innervation and shorter delay of terminal latency in myoelectrical response evoked by electrical stimulation of the sciatic nerve, compared with the vein-graft group at two and three months. But there were no differences between the two grafted groups after six months. In both grafted groups, the numbers of myelinated nerve fibers increased substantially over time, although the vein-grafted segments had smaller numbers of fibers than the nerve-grafted segments at both three and 12 months. Microangiograms also demonstrated different patterns of revascularization between the two groups. Results suggest that, although autologous vein grafting requires a longer period of time for nerve regeneration, compared with autologous nerve grafting, its ability to repair nerve is considerable.

A Biological Tube Technique For The Repair Of Peripheral Nerve Defects Using ‘Stuffed Nerves’

“…[4,16,27] Hence, the use of vein graft with other materials that benefit axonal growth will likely produce significant improvements in outcomes.…”

“…[13] However, the most frequently observed disadvantage of vein grafts is curling, which increases risk of collapse and fibrotic contraction. [14][15][16] Most successful vein graft repairs are observed in defects less than 3 cm in length. [14] Previous studies have demonstrated utility of filling inside of vein graft with nerve [17] or muscle…”

Peripheral Nerve Reconstruction with Autologous Grafts

“…They were used both to protect the site of nerve anastomoses and as nerve conduits, in a number of modifications. In the past, the use of nerve conduits in nerve reconstruction has provided results inferior to those obtained using nerve grafts; today we see a renewed interest both in venous grafts [22][23][24][25] and arterial grafts 26 , especially for short gap reconstruction (<3 cm).…”

“…28 Chiu and Strauch found that nerve gaps of 3 cm or less could be repaired successfully with vein conduit grafting and demonstrated their efficacy in both acute and delayed digital nerve repair. 22 Tang et al repaired nerve defects less then 3 cm long with vein conduit graft and the results were good to excellent in 61.1% of the injured digital nerves. 29 A potential drawback with vein grafting is that the vein wall may collapse.…”

A Novel Internal Fixator Device for Peripheral Nerve Regeneration

“…Nonautologous grafts can incorporate biological or synthetic components and have been designed with increasing complexity. Biological grafts include acellular nerve grafts or use skeletal muscle, 15,16 vein [17][18][19] , and tendon, 20 while synthetic NGCs have been fabricated with a variety of geometries, porosities, and material properties. 3,21 Grafts have also been designed to incorporate chemical and biological cues to encourage nerve regeneration, such as Schwann cells, stem cells, or neurotrophic factors.…”