title: Coating with paclitaxel improves graft survival in a porcine model of haemodialysis graft stenosis.
abstract: BACKGROUND
  Most commonly resulting from intimal hyperplasia at the venous anastomosis, stenosis leading to thrombosis is a major cause of failure of polytetrafluoroethylene (PTFE) dialysis grafts. We recently reported that coating haemodialysis grafts with paclitaxel could reduce neointimal hyperplasia. This study tested whether paclitaxel-coating could prolong graft survival in a porcine model.
  
  
  METHODS
  PTFE grafts were double-coated with paclitaxel. Bilateral grafts were created between the carotid arteries and the external jugular veins, and we evaluated graft survival by weekly measurements of blood flow for 12 weeks.
  
  
  RESULTS
  We successfully implanted four pairs of paclitaxel-coated grafts and four pairs of control grafts in eight Landrace pigs. One control pig had to be euthanized at 4 weeks after graft placement. The grafts in the other three controls and four paclitaxel pigs survived until harvesting of the grafts. All paclitaxel-coated grafts remained patent for 12 weeks without decrease of blood flow. Median blood flow was 702 ml/min at three weeks and 818 ml/min at 12 weeks after placement. In contrast, the four control grafts lost luminal patency at 5, 6, 6 and 8 weeks, respectively. In Kaplan-Meier analysis, paclitaxel-coated grafts showed better survival than uncoated grafts (P = 0.011).
  
  
  CONCLUSIONS
  Double-coating with paclitaxel improved graft survival. Coated PTFE grafts may be effective for the prevention of graft failure in patients on haemodialysis.
authors.affiliation: Division of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Korea 135-710.
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Lee
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Kwang Woong
authors.initials: KW
authors.lastname: Lee
authors.forename: Hye Yeong
authors.initials: HY
authors.lastname: Nam
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Jeon
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Sung
authors.forename: Jong Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Lim
authors.forename: Jong-Sang
authors.initials: JS
authors.lastname: Park
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Ko
authors.forename: Dae Joong
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000818:Animals; D020099:Coated Materials, Biocompatible; D003251:Constriction, Pathologic; D004195:Disease Models, Animal; D006084:Graft Rejection; D006085:Graft Survival; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D011138:Polytetrafluoroethylene / Q000737:chemistry; D011474:Prosthesis Design; D006435:Renal Dialysis / Q000295:instrumentation*; D013552:Swine; D013997:Time Factors; D050257:Tubulin Modulators / Q000008:administration & dosage*
chemical_list: D020099:Coated Materials, Biocompatible; D050257:Tubulin Modulators; D011138:Polytetrafluoroethylene; D017239:Paclitaxel