Small calibre biosynthetic bacterial cellulose blood vessels: 13-months patency in a sheep model.
OBJECTIVE
Many patients in need of bypass surgery lack graft material and current synthetic alternatives have poor performance. A 4 mm vascular graft composed of bacterial cellulose (BC) was developed and tested in pilot study in a large animal model.


METHODS
BC is a biopolymer made by the bacteria acetobacter xylinum. BC grafts (n = 16) with 4 cm length and 4 mm internal diameter were implanted bilaterally in the carotid arteries of eight sheep. No long-term antithrombotic therapy was administered. Patency was assessed with ultrasound. Histology, immunohistochemistry, and electron microscopy were performed after explantation.


RESULTS
Fifty percent of the grafts occluded within two weeks. One animal died with patent grafts after 14 days. In the three remaining animals 5/6 grafts were patent after nine months. Two animals were followed 13 months after implantation with 3/4 grafts patent at explantation. All patent grafts had confluent endothelial-like cells.


CONCLUSIONS
Biosynthetic small calibre vascular grafts made from BC can be patent for up to 13 months in sheep carotid arteries. BC is a potential material for small calibre grafts but patency in animal models needs to be improved before clinical studies can be planned.
Department of Cardiovascular Surgery and Anesthesia, Sahlgrenska University Hospital, Gothenburg, Sweden.
Carl Johan
CJ
Malm
Bo
B
Risberg
Aase
A
Bodin
Henrik
H
Bäckdahl
Bengt R
BR
Johansson
Paul
P
Gatenholm
Anders
A
Jeppsson
D000818:Animals; D001807:Blood Vessel Prosthesis; D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery / Q000648:ultrastructure; D002482:Cellulose / Q000378:metabolism; D042783:Endothelial Cells / Q000473:pathology; D004730:Endothelium, Vascular / Q000502:physiology; D041822:Gluconacetobacter xylinus / Q000378:metabolism; D006083:Graft Occlusion, Vascular / Q000473:pathology; D023421:Models, Animal; D012756:Sheep; D014654:Vascular Patency / Q000502:physiology
D002482:Cellulose