(Circulation. 1995;92:2605-2616.)
© 1995 American Heart Association, Inc.
Articles |
Seeding With Omental Cells Prevents Late Neointimal Hyperplasia in Small-Diameter Dacron Grafts
From the Clinic for Cardiovascular Surgery, Department of Surgery, University Hospital (M.P., W.M.-G., M.L., M.T.), Zurich, Switzerland; the Laboratory for Special Techniques, Department of Pathology, University Hospital (B.O.), Zurich; and the Department of Biostatistics ISPM, University of Zurich (B.S.), Switzerland.
Correspondence to Miralem Pasic, MD, PhD, Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax-, und Gefässchirugie, Augustenburger Platz 1, D-13353 Berlin, Germany.
Background The influence of complete endothelialization of a prosthetic graft on development of late neointimal hyperplasia is unknown. This study was designed to investigate the effect of complete coverage with endothelial-like cells on late neointimal hyperplasia in small-diameter Dacron grafts seeded with omental cells in a canine model.
Methods and Results Four-mm-ID Dacron grafts were seeded with cells from omentum and implanted in the carotid arteries in 24 mongrel dogs. Each dog received one seeded and one nonseeded graft. The graft patencies were assessed by angiography at 1, 5, 12, 26, and 52 weeks after surgery. The prostheses were explanted at 5, 12, 26, and 52 weeks after surgery and underwent microscopic studies. The actuarial patency rates at 1, 5, 12, 26, and 52 weeks were 100%, 95%, 95%, 95%, and 95% for seeded grafts and 100%, 86%, 49%, 40%, and 13% for nonseeded grafts, respectively. The seeded grafts exhibited a uniform endothelial-like luminal monolayer without the development of late neointimal proliferation or anastomotic neointimal hyperplasia. Neointimal tissue thickness increased up to 6 months; no additional progression of the subendothelial tissue thickness was observed, in fact there was an insignificant decrease.
Conclusions Seeding with omental cells prevents development of late neointimal hyperplasia of small diameter prosthetic vascular grafts in a canine model.
Key Words: cells • grafting • anastomosis • arteries • endothelium • atherosclerosis
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