title: Phosphorylcholine coating of ePTFE reduces platelet deposition and neointimal hyperplasia in arteriovenous grafts.
abstract: In an attempt to reduce platelet deposition and inhibit neointimal hyperplasia, we evaluated the effect of coating expanded polytetrafluoroethylene (ePTFE) grafts with phosphorylcholine (PC), a lipid found in animal cell membranes, in a dog model of femoral arteriovenous (AV) grafts. Eight mongrel dogs underwent placement of a PC-coated femoral AV graft on one side and an untreated control graft on the contralateral side. Platelet deposition was measured by autologous 111Indium-labeling and scintillation camera imaging analysis. Platelet deposition on the PC-coated grafts at 30 and 90 min. was 9.32 +/- 4.35 x 10(9) and 10.00 +/- 4.38 x 10(9), respectively, as compared with 10.26 +/- 4.36 x 10(9) and 11.64 +/- 5.08 x 10(9) platelet deposition on control grafts (P < 0.05). All grafts were patent at 4 weeks. There was a significant reduction of neointimal area at both arterial (0.07 +/- 0.05 mm2) and venous (0. 18 +/- 0.09 mm2) anastomoses in the treated grafts as compared with arterial (0.15 +/- 0.05 mm2) and venous (0.43 +/- 0.22 mm2) anastomoses in the control grafts (P < 0.05). In addition, neointimal cell proliferation assayed by bromodeoxyuridine (BrdU) incorporation was reduced in both arterial (2.05 +/- 0.81%) and venous (3.25 +/- 0.17%) anastomoses of treated grafts compared with arterial (3.12 +/- 1.23%) and venous (5.36 +/- 1.18%) anastomoses of control grafts (P < 0.05). These data demonstrated that PC coating of ePTFE grafts significantly reduced platelet deposition, anastomotic neointimal hyperplasia, and neointimal cell proliferation in a dog model of AV grafts. This may represent a new strategy for prolonging hemodialysis graft patency.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, 30322, USA.
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.forename: J C
authors.initials: JC
authors.lastname: Ofenloch
authors.forename: Y P
authors.initials: YP
authors.lastname: Yianni
authors.forename: S R
authors.initials: SR
authors.lastname: Hanson
authors.forename: A B
authors.initials: AB
authors.lastname: Lumsden
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D000963:Antimetabolites; D001792:Blood Platelets / Q000166:cytology*; D001973:Bromodeoxyuridine; D002455:Cell Division / Q000502:physiology; D004285:Dogs; D005263:Femoral Artery / Q000637:transplantation*; D005268:Femoral Vein / Q000637:transplantation*; D006085:Graft Survival / Q000502:physiology; D006965:Hyperplasia; D008297:Male; D008422:Materials Testing; D010767:Phosphorylcholine; D011138:Polytetrafluoroethylene; D017539:Tunica Intima / Q000473:pathology
chemical_list: D000963:Antimetabolites; D010767:Phosphorylcholine; D011138:Polytetrafluoroethylene; D001973:Bromodeoxyuridine