[Contact phase of blood coagulation and formation of thrombi in the blood vessel prosthesis].
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The resectability and prognosis of carcinoma of the pancreatic head are still poor. The higher resectability rate was achieved by combined resection of the pancreas and portal vein. Two patients in whom the portal vein, surrounded but not penetrated by pancreatic carcinoma, was resected and replaced by an expanded Teflon (Gore-Tex) tube (diameter 8 mm). One patient, who survived 32 months without recurrence of disease, had a ultrasonography and CT proved patent graft 6 and 32 months after operation. A second survivor had a patent graft at 20 month. Excision of involved portal vein during pancreatoduodenectomy for carcinoma of the head of the pancreas is a feasible and valid procedure in the absence of metastases. Vein grafting is the best means for portal vein reconstruction. Gore-Tex appears to be suitable prosthesis when the portal vein must be sacrificed.
This study investigated as a small diameter vascular replacement the tissue formed adjacent to an implanted cylindrical foreign body, heterologously transplanted. Grafts of 4 mm i.d. were grown in rabbits and transplanted to dogs as segmental carotid and femoral artery replacements. These maintained 50% patency after 3 weeks. Variables in the further development of this concept are discussed.
The authors have performed an experimental and clinical assessment of a new graft. In 37 mongrel dogs 49 experiments were carried out with the implantation of grafts "Vitaflon" into different parts of the arterial and venous bed. It was shown that the domestic graft from modified polytetraftoroethylene had high biological inertia, good plastic properties, zero surgical porosity, strength and reliable "taking" by the recipient's organism. Following the experimental work the prosthesis "Vitaflon" (30-50 cm long and 8 mm diameter) was implanted in the femoro-popliteal-tibial position to 15 patients suffering from obliterating atherosclerosis of the lower extremity arteries. The period of follow-up observations was about 12 months. Thrombosis took place in two grafts in the early postoperative period. Other shunts were functioning well which was confirmed by the clinical picture and dopplerography.