Evaluation of the healing of precoated vascular dacron prostheses

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Abstract
Gestrickte und gewebte Dacronprothesen mit kommerzieller Vorbeschichtung aus bovinem Kollagen, Gelatine oder humanem Albumin wurden bei 35 Schweinen End-zu-Seit zwischen infrarenaler Aorta und der Bifurkation implantiert. Die Prothesen wurden nach 4, 8 und 12 Wochen explantiert und mit 6 unbeschichteten gestrickten Dacronprothesen verglichen. Unbeschichtete Dacronprothesen entwickelten rasch eine fest haftende Neointima mit Endothelauskleidung, wobei die thrombusfreie Fläche gegenüber beschichteten Prothesen signifikant größer war (PP < 0.05). The slow resorption of albumin resulted in a delayed and incomplete neointimal healing and failing graft incorporation. Although the bovine collagen was only minimally cross-linked by formaldehyde, healing of the neointima was compromised in a thin woven graft that demonstrated peeling of the inner capsule even after 12 weeks. The identical collagen as well as bovine gelatin were quickly degraded in knitted grafts and both types showed transprosthetic infiltration at 4 weeks. All knitted grafts coated with either collagen or gelatin, however, were occluded after 8 and 12 weeks. Light microscopy revealed hyperplasia of smooth-muscle cells within the thickened distal anastomotic region. These results demonstrate that a timely return of porosity is mandatory for the development and maintenance of an intact neointima. Both the structure of the fabric as well as the method of preparing the coating are crucial variables to determine the rate of biodegradation.

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