A method to reduce thrombogenicity of a graft for small diameter arterial substitution seeded with autologous venous tissue fragments.
The authors successfully applied a method to accelerate endothelialization by tissue fragmentation to a small diameter fabric vascular prosthesis. Tissue fragment seeded grafts showed rapid healing of the neointima. The thrombogenicity of the collagen fibrils in the fragments, however, caused major problems when the method was applied to small diameter grafts: the positively charged collagen fibrils aggregated the negatively charged platelets. The authors masked the fibrils electrostatically with heparin molecules, which are negatively charged. A canine jugular vein was resected, minced into tissue fragments, and suspended in the heparin solution; it then was sieved through the wall of a fabric prosthesis. The grafts (4 mm internal diameter and 3.5 cm in length) were implanted into both carotid arteries of six dogs (12 grafts). Tissue fragment seeded grafts without heparin also were implanted into six dogs. As a control, preclotted fabric grafts were implanted into six dogs (12 grafts). These grafts occluded within 1 week, whereas all the masked grafts were patent without thrombi. In vitro examination of heparin release revealed that approximately 92% of heparin in the graft was released during the first 5 hr, but approximately 6% remained after 25 hr. These results indicate that the method is applicable to small diameter arterial grafts.
Noishiki
Y
Y
First Department of Surgery, Yokohama City University, School of Medicine, Japan.
Yamane
Y
Y
Tomizawa
Y
Y
Okoshi
T
T
Satoh
S
S
Kosuge
T
T
Ishii
M
M
Ichikawa
Y
Y
Kajiwara
H
H
Tomiyama
I
I
D000818:Animals; D001158:Arteries / Q000033:anatomy & histology / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects / Q000379:methods*; D004285:Dogs; D004730:Endothelium, Vascular / Q000033:anatomy & histology / Q000254:growth & development / Q000378:metabolism; D005069:Evaluation Studies as Topic; D006493:Heparin / Q000008:administration & dosage / Q000378:metabolism; D013927:Thrombosis / Q000517:prevention & control*; D014182:Transplantation, Autologous; D014680:Veins / Q000033:anatomy & histology / Q000637:transplantation
D006493:Heparin