Auswirkung von verschiedenen Gefäßklemmen auf die Kollagenmatrix der ovinen biosynthetischen Gefäßprothese
von Matus Svicin
Datum der mündl. Prüfung:2024-01-09
Erschienen:2024-03-04
Betreuer:Prof. Dr. Hassina Baraki
Gutachter:Prof. Dr. Hassina Baraki
Gutachter:Prof. Dr. Jens Jakob
Dateien
Name:Svicin_Matus_Dissertation_zur_SUB.pdf
Size:10.7Mb
Format:PDF
Zusammenfassung
Englisch
Background: Ovine biosynthetic prostheses have established themselves in the field of vascular surgery; they can be used effectively both for septic vascular surgery – in cases where there are no autogenous bypass materials – and in shunt surgery. Great care must be taken when manipulating the biosynthetic prosthesis during the surgical interventions since it is suspected that any type of damage to the collagen matrix can later cause the onset of local complications. Literature reports an incidence of local complications, especially the onset of pseudoaneurysm, in up to 7% of cases. It is suspected that the clamping area could act as a typical predilection site for the onset of (pseudo-) aneurysms. Use of the Omniflow prosthesis without manipulation, e.g., a clamping maneuver, is not impossible during vascular surgical implantation but is impractical. Against this backdrop, this paper focuses on the various influence factors related to the Omniflow prosthesis clamping maneuver. Material and methods: As part of the series of tests, the vascular prosthesis was connected to an experimental external circulation system. The system was powered by a centrifugal pump and supported by a pulsatile pressure system to reflect systemic circulatory conditions (pulsatility, heart rate, systolic and diastolic pressure). Subsequently, with continuous operation of the circulatory system, the prosthesis was clamped using various types of vascular clamps. Multiple testing series were conducted using various clamping times, differing numbers of clamping procedures, and multiple clamp profiles. The processed prostheses were fixated for microscopic examination and underwent H&E staining. The focus of further microscopic examination was the grade of collagen fibril damage. Results: We observed no definitive clamping-related damage to the collagen matrix in a total of 108 histological samples. There were significant differences between the analyzed clamp types. We were able to identify a low-impact clamping technique to increase the practicability of the Omniflow II prosthesis.
Keywords: biosynthetic grafts; Omniflow II; vascular graft; vascular clamp