Observations on Arterial Homografts with Special Reference to Pathologic Changes
WILLIAM A. HAWK, M.D.
Department of Pathology
ALFRED W. HUMPHRIES, M.D.
Department of Vascular Surgery
ARTERIAL HOMOGRAFTS offer a bright promise to those patients who have advanced arterial disease of the major peripheral arteries and the distal aorta. In the present series, a diseased segment of a vessel has been replaced by a homograft in 264 patients, the majority of whom since have shown great clinical improvement. In nine patients in whom the homografts failed either during the immediately postoperative period or during the ensuing 18 months, the homografts were recovered for critical analysis at reoperation or at necropsy. The findings on these studies are presented in this report.
Materials and Methods
Nine homografts were available for study; five of these were recovered from 4 to 8 weeks and four from 9 to 18 months after the primary operation. Changes observed in the homografts in the early group were similar, and one was chosen for this report as representative for the preparation of photomicrographs and for comparison with the older segments.
All of the recovered homografts were processed in the same way. Blocks were taken from the central portion of the homografts and anastomotic lines, usually after fixation of the main portions of the specimen in Zenker's solution. The sections were stained with hematoxylin-eosin-methylene blue, Verhoeff's stain counterstained by the Van Gieson's method, Masson's trichrome stain, and Gomori's elastic tissue stain. Frozen sections were made on formalin-fixed segments and were stained with Sudan IV for lipids.
An unused freeze-dried femoral homograft was reconstituted as though for operative substitution and then was studied according to the. . .