No abstract

Patch grafting of small arteries is a relatively recent procedure( 1-5) that is increasing in significance as the technique is improved and the application widens. Small canine arteries were patch grafted with autogenous veins of whole thickness to permit study of the intimal surface.MateriaEs and methods. Autogenous vein patch grafts were placed in 22 femoral arteries of 13 dogs. Microsurgical technique was used. The grafts were sutured with 7-0 black silk. Patches were placed in the midportions of the superficial femoral arteries where the external diameter was 0.2 to 0.4 cm. Patches used were 0.9 to 3 cm long and 0.3 to 0.4 cm wide, and were taken from adjacent femoral or saphenous veins. The patch was sutured into a longitudinal slit made in the recipient artery. The animals were observed for periods from 2 to 53 1 days. Peripheral pulses were recorded at weekly intervals. Prior to termination of the experiment, patency was demonstrated by aortography. The removed specimen was placed in physiologic saline. Silver nitrate solution, 0.4%, was then applied to the intimal surface. After rinsing and immersion in 10% formalin, the intimal surface was exposed to a sunlamp until it darkened. The specimens were then studied en face. Subsequently, pellicle preparations were stained with hematoxylin and eosin (6). Conventional microscopic preparations were also made from cross sections of the arteries with the patch, and were stained with hematoxylin and eosin, Weigert's elastic tissue stain, or Masson's trichrome stain.Observations. Healing was studied on 11 arteries with patches in place for 2,2,4, 14, 22, 30, 35, 45, 55, 60, and 66 days respectively; and on 11 arteries with patches in place for 18, 25, 32, 39, 45, 49, 57, 70, 72, 74, and 76 weeks respectively. In every grafted artery, arteriography disclosed complete patency with no or slight dilatation at the site of operation. This is well illustrated in an arteriogram (Fig. 1) of dog MM 50 with patches in place for 4 days (left) and 66 days (right) respectively. The patency of the arteries with patches in place for 45 and 70 weeks, respectively, is illustrated in Fig. 2 (FF 72). FIG. 1. Arteriogram of femoral arteries with venous patches in place for 4 days (left) ar.d 66 days (right), respectively. Sites of the patches are hardly discernible. FIG. 2. Arteriogram of femoral arteries with venous patches in place for 45 weeks (right) and '10 weeks (left), respectively. Only slight irregularity of contour is discernible. FIG. 3. Gross appearance of inner surface of artery with patch in place for 35 days. Silk sutures are covered by a smooth membrane. Patch is slightly elevated above the surface. X 2.FIG. 4. Appearance of inner surface of the artery with patch in place for 66 days is similar to that in Fig. 3. X 2. FIG. 5 . En face silver preparation of patch in place for 30 days. The mosaic pattern of silver stained cell borders is clearly outlined. X 100.FIG. 6. Pellicle preparation stained also with hematoxylin and eosin reveals the celI nuclei within the endothel...