Abstract
In addition to the polytetrafluoroethylene (PTFE) vascular graft (G) with its conventionally smooth surface, a unique PTFE graft with a ridged outer wall (T) is now also currently available for clinical use. Although an excellent antikinking property is provided by this unique outer structure, the possible influence of the structure on the formation of pseudointima has not yet been investigated in detail. Four kinds of T grafts (3 mm inner diameter, 3 cm long) with various fibril lengths (FL, T-15, T-30, T-60, T-90) and a G graft with 30 μm FL (G-30) were implanted into the inferior vena cava of rabbits. The patency of the grafts at 4 weeks were as follows: 6/8(T-15), 6/8(T-30), 5/8(T-60), 0/8(T-90) and 4/6 (G-30). Pseudointimal hyperplasia (PH) of the T grafts advanced as the FL increased, judging by the thickness of the pseudointima, cellular density, and maturity of fibroblasts. In addition, the maturity of endothelial-like cells on the luminal surface increased as the FL increased. The degree of pseudomintimal hyperplasia in G-30 was comparable to that of T-15, although the maturity of the endothelial-like cells was similar to that of T-60. Microscopically, there was a microheterogeneity of cellular density in T grafts probably due to the uneven outer structure. In conclusion, not only FL but also the outer structure of PTFE may thus influence the formation of the pseudointima.
Similar content being viewed by others
References
Kambayashi J, Watase M, Itoh T, Kawasaki T, Shiba E, Sakon M, Mori T (1992) Blood compatibility of venous prostheses made of textile or non-textile material. Thrombos Res 66:365–372
Watase M, Kambayashi J, Itoh T, Tsuji Y, Kawasaki T, Shiba E, Sakon M, Mori T, Yashika K, Hashimoto H (1992) Ultrastructural analysis of pseudo-intimal hyperplasia of polytetrafluoroethylene prostheses implanted into the venous and arterial system. Eur J Vasc Surg 6:371–380
Ishikawa M, Yamazaki T, Yano H, Fujikawa T, Konagai N, Obitsu Y, Yao Y, Tsuchida H, Motoyasu S, Hirayama T, Ishimaru S, Furukawa K (1993) Six-year experience with wrinkled ePTFE vascular prostheses for arteriosclerosis obliterance. ASAIO J 39:M522-M525
Clowes AW, Gown AM, Hanson SR, Reidy MA (1985) Mechanisms of arterial graft failure. 1. Role of cellular proliferation in early healing of PTFE prostheses. Am J Pathol 118:43–54
Clowers AW, Kirkman TR, Reidy MA (1986) Mechanisms of arterial graft healing. Rapid transmural capillary ingrowth provides a source of intimal endothelium and smooth muscle in porous PTFE prostheses. Am J Pathol 123:220–230
Shibuya T, Kambayashi J, Okahara K, Kim DI, Kawasaki T, Sakon M, Shiba E, Mori T (1994) Subendothelial layer of pseudointima of polytetrafluoroethylene graft is formed by transformation of fibroblasts migrated from extravascular space. Eur J Vasc Surg 8:276–285
Volder JGR, Kolff WJ (1974) Induced growth of connective tissue in cardiovascular prostheses. Trans Am Soc Artif Int Organs 20:521–529
Campbell CD, Goldfarb D, Detton DD, Roe R, Goldsmith K, Diethrich EB (1974) Expanded polytetrafluoro-ethylene as a small artery substitute. Trans Am Soc Artif Int Organs 20:86–90
Campbell CD, Goldfarb D, Roe R (1975) A small arterial substitute. Expanded microporous polytetrafluoroethylene: patency versus porosity. Ann Surg 182:138–143
Kogel H, Vollmar JF, Cyba-Altunbay S, Mohr W, Frosch D, Amselgruber W (1989) New observation on the healing process in prosthetic substitution of large vein by microporous grafts animal experiments. Thorac Cardiovasc Surg 37:119–124
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Shibuya, T., Kambayashi, Ji., Kim, DI. et al. Pseudointimal hyperplasia of ridged outer wall polytetrafluoroethylene vascular prostheses. Surg Today 26, 333–339 (1996). https://doi.org/10.1007/BF00311602
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00311602