title: Evaluation of a novel vascular graft with a distal bifurcation designed to reduce the development of intimal hyperplasia. Experimental study in a porcine aorta model.
abstract: OBJECTIVE
  Abnormal haemodynamics is commonly agreed to be a major contributor to the development of distal anastomotic intimal hyperplasia. A new vascular graft design proposed by computational studies was used to demonstrate its surgical feasibility and to compare it with the conventional graft in a porcine model.
  
  
  METHODS
  The device was used in 12 eight-month-old pigs, six received the new graft and six had a conventional graft. The proximal graft end was implanted into the aorta, the distal graft end was implanted into the iliac artery. The host artery was ligated in order to simulate occlusion. At 20 weeks after surgery the pigs were killed and the device was excised for histological and morphometric analysis.
  
  
  RESULTS
  In five experimental grafts the reconstruction was occluded due to thrombosis; only one prosthesis was patent showing a minimum of neointimal hyperplasia. In the control group too only three of the six grafts were patent. A histological analysis revealed, as the cause of occlusion, fibrous tissue overgrowth corresponding in structure to neointimal hyperplasia. Differences in the number of obliterations and in occlusion rates between the profiles of the two groups were evaluated using the median test (P<0.05). The results were not statistically significant.
  
  
  CONCLUSIONS
  Although mathematical modelling had shown significant haemodynamic benefits of a naturally bifurcated graft, our study did not confirm its superiority over conventionally used prostheses.
authors.affiliation: Second Department of Surgery, St. Anne's University Hospital in Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Vlachovsky
authors.forename: Robert
authors.initials: R
authors.lastname: Staffa
authors.forename: Martin
authors.initials: M
authors.lastname: Dvorak
authors.forename: Michal
authors.initials: M
authors.lastname: Vlasin
authors.forename: Marketa
authors.initials: M
authors.lastname: Hermanova
authors.forename: Thomas
authors.initials: T
authors.lastname: O'Brien
authors.forename: Timothy
authors.initials: T
authors.lastname: McGloughlin
mesh_terms: D000818:Animals; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D004730:Endothelium, Vascular / Q000473:pathology; D005240:Feasibility Studies; D006965:Hyperplasia; D011474:Prosthesis Design; D013552:Swine; D017539:Tunica Intima / Q000473:pathology*