Hybrid small-caliber vascular prosthesis for coronary artery bypass grafting: a preliminary study of plasmin-treated fibrin-coated vascular prosthesis.
The potential use of plasmin-treated fibrin-coated vascular prosthesis (PF-V) for coronary artery bypass grafting (CABG) in animal models was investigated. PF-V grafts, 3 mm in internal diameter, were studied on 5 sheep in off-pump CABG model and on 18 rabbits in abdominal aortic bypass grafting (AABG) model. Patency, blood flow, angiography, Indium-111 platelet scintigraphy, and histology of the graft were evaluated. In the sheep CABG model, the PF-V grafts were patent for a range of 12 to 22 days without postoperative antiplatelet therapy. Graft flows ranged 58 to 90 ml/min until the day before graft occlusion by thrombus. In rabbit AABG model, the fibrin coating of the PF-V grafts was completely absorbed and replaced with neofibrin net between 7 and 14 days after implantation. Platelet depositions on the graft between 7 and 14 days after implantation were significantly higher than those at other periods (p < 0.05). The small-caliber PF-V graft in sheep CABG model had a good blood flow with high antithrombogenicity in acute phase, but occluded over 2 to 3 weeks without antiplatelet agents after implantation. The current problem of the PF-V graft was a thrombus formation at the time of the degradation of fibrin coating. Further improvements are needed.
Hasegawa
Tomomi
T
Division of Cardiovascular, Thoracic, and Pediatric Surgery, Department of Cardio-Pulmonary and Vascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Okada
Kenji
K
Takano
Yoshihito
Y
Hiraishi
Yoshiaki
Y
Yoshida
Yoshihiro
Y
Okita
Yutaka
Y
D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D005337:Fibrin; D005341:Fibrinolysin; D006801:Humans; D008422:Materials Testing; D011474:Prosthesis Design; D011817:Rabbits; D012756:Sheep; D013499:Surface Properties; D013927:Thrombosis / Q000209:etiology / Q000473:pathology
D001672:Biocompatible Materials; D005337:Fibrin; D005341:Fibrinolysin