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Evaluation of a polyester collagen-coated heparin bonded vascular graft
J P Becquemin1, Y Riff, S Kovarsky
1Service of Vascular Surgery, Hospital Henry Mondor (Creteil), France.
Insights
Comparing collagen coated heparin bonded vascular grafts (CHG) and collagen coated grafts (CG) in dogs showed no significant difference in blood loss or healing. The CHG group had a thinner internal layer at six months.
Area of Science:
- Vascular Surgery
- Biomaterials Science
- Regenerative Medicine
Background:
- Vascular grafts are crucial for bypassing damaged arteries.
- Heparin bonding aims to improve graft biocompatibility and healing.
- Polyester grafts are commonly used but can elicit inflammatory responses.
Purpose of the Study:
- To compare collagen coated heparin bonded vascular grafts (CHG) with collagen coated grafts (CG).
- To evaluate differences in intraoperative blood loss and the graft healing process.
- To assess the patency and histological characteristics of both graft types.
Main Methods:
- Implantation of 12 CHG and 12 CG polyester grafts (6 mm diameter, 5 cm length) into the common iliac artery of 12 adult dogs.
- Graft explantation and evaluation between 1 and 6 months post-implantation.
- Assessment of healing via gross, microscopic, and scanning electron microscopy; measurement of prostaglandins (PGE2, TXB2, 6-keto-PGF1α, PGF2α) via radioimmunoassay.
Main Results:
- No significant difference in intraoperative blood loss between CHG and CG groups.
- 20 out of 24 grafts remained patent at explantation (10 CHG, 10 CG).
- Progressive healing observed in both groups, with 90% endothelial-like cell coverage by 6 months; CHG grafts showed a thinner internal layer at 6 months.
- Prostacyclin (PGI2) secretion was detected in both graft types.
Conclusions:
- Collagen coated heparin bonded grafts (CHG) and collagen coated grafts (CG) demonstrate comparable blood loss and healing characteristics in this canine model.
- A potentially thinner internal graft layer was observed in the CHG group at 6 months.
- Further clinical studies in humans are warranted to determine the practical benefits of heparin-bonded grafts in vascular surgery.
Abstract:
This animal study was designed to compare a collagen coated heparin bonded vascular graft (CHG) versus a collagen coated vascular graft (CG) regarding intraoperative blood loss and healing process. 24 polyester vascular grafts (12 CHG and 12 CG) of 6 mm in diameter and 5 mm in length were implanted between the common iliac and external iliac artery in 12 adult dogs. The grafts were explanted between the first and the sixth months which followed the implantations. The healing process was observed by gross examination, microscopic and scanning electron microscopic examination. Prostaglandin PGE2, TXB2, 6 keto PGF1 alpha and PGF2 alpha were measured by radioimmunologic assay from samples retrieved from the medium part of the graft. During implantation, there was no notable difference in blood loss through the graft. At the time of explantation, 20 grafts were patent (10 CHG, 10 CG). In both grafts, the healing process developed progressively between 2 and 6 months and 90% of the internal surface of the grafts were covered with endothelial like cells. At 6 months, the internal layer was thinner in heparinized graft. PGI2 secretion was found with the two types of grafts. In conclusion, the present study showed no difference in the blood loss or healing characteristic of CHG and CG except for a potentially thinner internal layer with CHG. Comparative studies in humans are necessary to evaluate the potential benefit of heparin bonded graft in clinical practice.