[Venous replacement surgery: history, update and perspectives].
The impulse given to vascular surgery by new technologies has facilitated the use of the bypass technique in a number of arterial pathologies with better and better results over time. At the moment, however, we haven't a "sure prosthesis" in venous surgery. Our intention has been to examine the most significant developments, studying all the available material dating from the beginnings of the art up to the present. After a careful examination of the venous pathophysiology as well as the most valid surgical approaches, we tried to evaluate on laboratory animals the results of experimental graft replacement of the inferior vena cava. In this study we analysed prostheses in PTFE, biological prostheses, spiral composite vein grafts, arterial autologous grafts. For the experimental study we used 55 rabbits (New Zealand and Fiandra). Results have been rather successful with respect to biological prostheses (62.5% patency) and PTFE (66.6%). As for spiral composite vein graft prosthesis patency over time was very low (16.6%); this was affected by the different venous graft (heterologous graft) and caval wall thicknesses. Arterial autologous graft was carried out only once because rabbit experimented on did not stand up to surgical stress.
Mongardini
M
M
Ill Clinica Chirurgica Generale e Térapia Chirurgica, Università degli Studi La Sapienza, Roma.
Benedetti
F
F
Chiarini
S
S
Palazzini
G
G
D000818:Animals; D001807:Blood Vessel Prosthesis; D002415:Cats; D004285:Dogs; D006801:Humans; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011817:Rabbits; D012106:Research; D014680:Veins / Q000601:surgery* / Q000637:transplantation
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene
La chirurgia sostitutiva venosa: storia, attualità, prospettive.