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Related Experiment Videos

Prosthetic replacement for the thoracic vena cava: an experimental study.

A C Fiore, J W Brown, R S Cromartie

    The Journal of Thoracic and Cardiovascular Surgery
    |October 1, 1982
    PubMed
    Summary

    Externally stented polytetrafluoroethylene (PTFE) grafts showed excellent patency rates in canine thoracic venous replacement, matching autologous veins. This stented PTFE offers a promising alternative for venous conduits.

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    Area of Science:

    • Vascular surgery
    • Biomaterials science
    • Regenerative medicine

    Background:

    • The superior vena cava (SVC) and thoracic inferior vena cava (IVC) are critical venous structures.
    • Graft materials for venous reconstruction require high patency rates and biocompatibility.
    • Autologous veins serve as a gold standard but have limitations.

    Purpose of the Study:

    • To evaluate the patency and biocompatibility of various graft materials for SVC and thoracic IVC replacement in a canine model.
    • To compare the efficacy of externally stented polytetrafluoroethylene (PTFE) against other materials.

    Main Methods:

    • Vascular grafts including autologous vein, knitted Dacron, glutaraldehyde-fixed porcine pericardium, unsupported PTFE, and externally stented PTFE were implanted in 46 dogs.

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  • Patency was assessed at 30 days using contrast venography.
  • Graft incorporation and neointima formation were evaluated histologically.

    • Main Results:

    • Patency rates at 30 days were: autologous vein (100%), Dacron (9%), porcine pericardium (50%), unsupported PTFE (75%), and stented PTFE (100%).
    • Dacron and porcine pericardium showed significantly lower patency than autologous vein (p < 0.05).
    • Stented PTFE demonstrated excellent patency, minimal host reaction, good fibroblast incorporation, and a smooth neointima.

    Conclusions:

    • Externally stented PTFE achieved patency comparable to autologous veins in thoracic venous replacement.
    • The external support significantly enhanced the thromboresistance of PTFE grafts.
    • Stented PTFE is a promising candidate for venous reconstruction, warranting long-term follow-up.