Experimental study of the influence of porosity on development of neointima in Gore-Tex grafts: a method to increase long-term patency rate.
The objective of this study was to evaluate the controlled microscopic development and fate of the neointima of Gore-Tex graft pretreated with multiple regular perforations, compared to nonperforated controls. Gore-Tex grafts (each 7 cm x 8 mm), perforated at regular 2 mm intervals with a special needle (0.8 mm internal diameter) for one half the length, with the remaining half kept intact, were implanted in 37 canine abdominal aortas in an end-to-end fashion. Standard untreated Gore-Tex grafts, of identical size, were similarly implanted in ten as controls. The perforated portion of the artificially treated Gore-Tex grafts demonstrated early neointimization at one week, the presence of fibroblasts and developing vasovasorum at 4 weeks, and complete endothelialization at 12 weeks. In contrast, the unperforated portion of implanted grafts demonstrated delayed endothelialization, requiring 24 weeks for complete development. Untreated controls demonstrated incomplete healing of the central luminal portion of the graft, with reddish thrombi still present at 24 weeks. Our study demonstrated that the poor development of neointima persists in the central portion of standard Gore-Tex controls in the last postoperative period, while pretreatment with multiple small perforations significantly hastens the development of a smooth neointima.
D000818:Animals; D001012:Aorta, Abdominal / Q000166:cytology / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000592:standards*; D004285:Dogs; D004727:Endothelium / Q000166:cytology / Q000473:pathology; D008855:Microscopy, Electron, Scanning; D011138:Polytetrafluoroethylene; D013927:Thrombosis / Q000473:pathology*; D013997:Time Factors
D011138:Polytetrafluoroethylene