| Popis: |
The work that comprises this thesis was carried out to determine the effect of a novel method of endothelial cell seeding on the function of small calibre prosthetic vascular grafts. The introduction (Section 1) comprises five parts. Chapter 1 discusses the pathophysiology and treatment of peripheral vascular disease at the present time. Chapter 2 discusses the results of present day infrainguinal bypass surgery based on a 9 - year study in Leicester. Chapter 3 is concerned with reasons behind arterial bypass graft failure and Chapter 4 discusses the numerous functions of the endothelial cell, the cell which in fact forms the central theme of this thesis. In Chapter 5 there follows a review of the work carried out on endothelial cell seeding to date. Five experimental chapters are then presented in two sections. Section 2 comprises work carried out in vitro and includes three chapters. The first describes experiments used to find the optimum cell seeding surface. The next describes the development of a new method of cell seeding, based on the formation of confluent monolayers of cells on the graft luminal surface. The final part of Section 2 describes experiments to determine the effect of blood flow on these monolayers. Section 3 then comprises two chapters describing work carried out in vivo, in a canine model. The first chapter examines the effect of autologous, large vessel, venous endothelial cell seeding on the patency, thrombogenicity and function of 4 mm polytetrafluoroethylene grafts. The final experimental chapter describes, in a similar way, the effect of microvessel endothelial cells on the same parameters. In the final section (Section 4), the overall experimental results are reviewed and conclusions documented. This is followed by a discussion on possible, future avenues of research arising from the work in this thesis. |
