Implant site: A determinant of completeness of arterial prosthesis healing in the dog and possibly in humans
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This paper compares the healing of supported knitted Dacron prostheses implanted in the descending thoracic aorta and in the subcutaneous carotid-femoral positions in each of 10 dogs. The descending thoracic aorta prostheses were 6 cm long and the carotid-femoral prostheses averaged 76 cm in length. The healing of four porous clinical axillofemoral grafts is compared to that of the experimental carotid-femoral grafts. There was little similarity between the healing observed in the descending thoracic aortic and subcutaneous positions; the descending thoracic aorta grafts healed rapidly and completely by eight weeks, with thrombus-free flow surfaces covered with confluent endothelial cells. However, the inner wall of the carotidfemoral grafts remained largely unhealed at one year, with endothelialization largely confined to a limited pannus ingrowth across the anastomoses. This indicates that the implant site in the dog is a primary determinant of the rapidity and completeness of healing. The clinical axillofemoral grafts explanted after 20 months to six and one-half years exhibited healing characteristics that were similar to those seen in the carotid-femoral position in the dog. These findings suggest that valid comparisons of interspecies healing require data obtained from similar implant locations. They present a challenge to the previously held concepts of major interspecies differences in speed and extent of tissue ingrowth based on data obtained from noncomparable implant sites.
Key WordsArterial prostheses long-length arterial prostheses axillofemoral grafts carotid-femoral grafts interspecies healing comparisons
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- 3.WESOLOWSKI SA, FRIES CC, HENNIGAR G, FOX LM, SAWYER PN, SAUVAGE LR. Factors contributing to long-term failures in human vascular prosthetic grafts.J Cardiovasc Surg 1964;5:3–17.Google Scholar
- 4.DIDISHEIM P. Species selection for vascular graft evaluation. In: KAMBIC HE, KANTROWITZ A, SUNG P (eds). Vascular Graft Update: Safety and Performance. Philadelphia: American Society for Testing and Materials, 1986, p 174.Google Scholar