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
研究目的：通过多普勒血流测定法、静脉造影术、组织学检测及临床转归，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中的应用效果。
方法：将8只成年犬行股静脉重建术，左侧采用BP管状移植物，右侧采用自体静脉移植作为对照。术后对受试犬开展临床评估与股静脉多普勒血流检测。术后360天时对受试犬再次手术，使用碘对比剂行股静脉造影术，随后切除含移植物的股静脉段并送检组织病理学。
结果：受试犬均未出现出血、血肿、手术切口感染或术侧肢体水肿，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移植物组中有3支（37.5%）移植物保持通畅，对照组（C）中有7支（87.5%）移植物通畅。组织病理学检测发现，两组移植物外表面均出现以中性粒细胞和淋巴细胞为主的炎症反应；两组移植物内膜层及外层均可见纤维化改变。
结论：基于本实验模型的研究结果，BP具备作为管状移植物用于静脉血管重建的潜力。但仍需开展进一步研究以验证其在中、大直径静脉血管重建中的有效性，进而为其临床应用提供依据。