In vitro and in vivo characterization of a silk fibroin-coated polyester vascular prosthesis

Silk fibroin (SF) is well known to be biocompatible, degradable, and nontoxic. In this study, SF was impregnated into a porous polyester graft (InterVascular external velour, InterVascular, Inc., La Ciotat, France), 8 mm in diameter. The SF-impregnated graft was investigated in vitro and in vivo to evaluate its potential for use as a new vascular graft impervious to blood, while retaining high porosity for tissue ingrowth and biological healing. For in vitro investigation, the water permeability, coating weight, morphology, and mechanical properties of the SF-impregnated grafts were compared with collagen-coated grafts (InterGard grafts, InterVascular, Inc.). The water permeability of the controls (1388 +/- 30.5 mL/cm(2)/min at 120 mm Hg) was reduced >99% by SF impregnation, rendering the graft impervious to blood. The coating weight of the collagen was 117 +/- 22 mg/g of graft, producing a slightly lower value than the InterGard prosthesis (302 +/- 23 mg/g). For the in vivo experiment, six SF-sealed vascular grafts were implanted in the abdominal aorta of dogs for scheduled periods ranging from 4 h to 6 months. Commercial collagen-impregnated grafts (InterGard) and untreated external velour grafts (InterVascular) were also implanted for scheduled periods ranging from 1 to 6 months for comparison. Gross observation of the explanted grafts and histological examination of the representative sections were conducted for two types of grafts using a light microscope after hematoxylin-eosin staining. These SF-impregnated grafts showed less foreign body and inflammation reactions, and the SF layer was almost completely absorbed. The average of the values in each period for the SF grafts was 48% neointima at 1 month, 85% at 3 months, and 97% at 6 months, whereas those of the InterGard prostheses was 34, 46, and 90%, respectively. This study demonstrated that the use of a biodegradable SF as biological sealant can be a feasible approach to prepare impervious textile arterial prostheses. The SF-impregnated graft showed less thrombogenesis and induced host cell migration along the matrix without foreign body or inflammatory reactions. Moreover, it appears to facilitate the development of endothelial-like cells.