Enhanced perigraft angiogenesis prevents prosthetic graft infection.
BACKGROUND
Prosthetic vascular graft infection is an unsolved fatal complication after aortic surgery. We hypothesized that increased vascularity around a prosthetic graft may exert a preventive role against bacterial infection.


METHODS
Eighty-three Fischer rats were divided into five groups according to the types of subcutaneously implanted prosthetic graft and granulocyte-colony stimulating factor (G-CSF) treatment. The groups G and C had gelatin hydrogel microspheres-incorporated graft (gel graft) with or without concomitant systemic administration of G-CSF (50 microg/kg), respectively. The groups FG and F had the gel graft impregnated with 100 mug of basic fibroblast growth factor (bFGF) with or without systemic G-CSF. The group N received untreated grafts. Seven days after graft implantation, broth containing methicillin-sensitive Staphylococcus aureus (4.0 x 10(3) colony-forming units) was inoculated onto the graft. All the grafts and the surrounding tissues were explanted 2 days later. Quantitative culture for methicillin-sensitive Staphylococcus aureus from the grafts and histologic assessment for capillary number in the tissue were performed.


RESULTS
Positive infection rates in the groups N, C, and G were 34.7%, 30.4%, and 15.3%, respectively; whereas those were zero in the F and FG groups. Tissue around the grafts demonstrated significantly higher number of capillaries in the groups F and FG compared with the groups C and G. The number of bacterial colonies inversely correlated with the number of capillaries around the implanted graft (r = -0.32, p < 0.05).


CONCLUSIONS
Basic fibroblast growth factor incorporated into a prosthetic graft with or without systemic G-CSF can induce angiogenesis around the graft and prevent prosthetic graft infection.
Sato
Shinichi
S
Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Japan.
Nitta
Yoshio
Y
Saiki
Yoshikatsu
Y
Kawamoto
Shunsuke
S
Iguchi
Atsushi
A
Kaku
Mitsuo
M
Tabata
Yasuhiko
Y
Tabayashi
Koichi
K
D000818:Animals; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D004195:Disease Models, Animal; D005346:Fibroblast Growth Factors / Q000494:pharmacology*; D006084:Graft Rejection / Q000473:pathology; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D007150:Immunohistochemistry; D008297:Male; D018919:Neovascularization, Physiologic / Q000187:drug effects* / Q000502:physiology; D011336:Probability; D016459:Prosthesis-Related Infections / Q000473:pathology / Q000517:prevention & control*; D011897:Random Allocation; D051381:Rats; D011916:Rats, Inbred F344; D012016:Reference Values; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000517:prevention & control*
D016179:Granulocyte Colony-Stimulating Factor; D005346:Fibroblast Growth Factors