Experimental study of femoral vein reconstruction with sugarcane biopolymer tubular graft.

ABSTRACT Objective: to evaluate, through Doppler flowmetry, venography, histology and clinical evolution, the use of sugarcane biopolymer (BP) tubular grafts in the reconstruction of femoral veins in dogs. Methods: we submitted eight adult dogs to femoral vein reconstruction, on the left with BP tubular graft and on the right with autologous vein. In the postoperative period, the animals underwent clinical evaluation and femoral vein Doppler flowmetry. After 360 days, we reoperated the dogs and submitted them to femoral vein phlebography with iodinated contrast. We removed the segments of the femoral veins containing the grafts and sent them for histopathological evaluation. Results: the dogs did not present hemorrhage, hematoma, surgical wound infection or operated limb edema. One animal had superficial venous dilatation in the left inguinal region. Phlebography performed 360 days after the first surgery showed that three (37.5%) BP grafts and seven (87.5%) grafts from the control group (C) were patent. In the histopathological evaluation, we found an inflammatory reaction, with neutrophils and lymphocytes on the external surface of both groups. In the intimal layer of the grafts and in the outer layer in the two groups, we observed fibrosis. Conclusion: based on the results obtained with the experimental model used, BP presents potential to be used as a tubular graft for venous revascularization. However, new research must be performed to confirm its efficacy in the revascularization of medium and large diameter veins, which could allow its use in clinical practice.摘要 目的：本研究拟通过多普勒血流检测、静脉造影、组织学分析及临床随访，评估甘蔗基生物聚合物（sugarcane biopolymer, BP）管状移植物在犬股静脉重建术中的应用价值。 方法：选取8只成年犬实施股静脉重建手术，左侧术区植入BP管状移植物，右侧术区采用自体静脉作为对照。术后对所有受试动物进行临床评估及股静脉多普勒血流检测。术后360天，对受试犬再次实施手术，经碘化造影剂行股静脉造影，切除包含移植物的股静脉段，送检组织病理学检测。 结果：所有受试犬均未出现出血、血肿、手术切口感染或术肢水肿症状；仅1只受试犬左侧腹股沟区出现浅表静脉扩张。首次术后360天的静脉造影结果显示，BP移植物组有3支（37.5%）移植物保持通畅，对照组自体静脉移植物组有7支（87.5%）移植物保持通畅。组织病理学检测结果显示，两组移植物外表面均出现以中性粒细胞与淋巴细胞介导的炎症反应；两组移植物内膜层及外层均可见纤维化改变。 结论：基于本实验模型所得结果，BP管状移植物具备用于静脉血管重建的应用潜力。但仍需开展后续研究以验证其在中、大直径静脉血管重建中的疗效，进而为其临床应用提供依据。