Macroporous Textile and Microporous Nonwoven Vascular Prostheses: Histological Aspects of Cellular Ingrowth into the Structure

  • C. R. Jerusalem
  • F. Hess
Conference paper


The trellis concept of healing is suspended by the preclotting of the porous prosthetic fabric.

The absorption of the precoagulated blood and an occasional periprosthetic hematoma does not take place as rapidly as is usually surmized. Therefore, the presence of unorganized blood coagula can inhibit the stabilization of a fibrin layer which forms an early blood flow interface and can result in thrombotic complications.

Subsequently, the development of a cellular neointima which spreads exclusively from vascular tissues at the anastomotic site is impeded.

In contrast, the coated prosthesis (UNI-GRAFT {R} DV) can be used immediately without prior preclotting, thus also in patients being heparinized or suffering from coagulopathy.

The coating effectively prevents the imbibition of the prosthetic wall with blood as well as primary and secondary bleeding into the prosthetic bed. The coating smoothes the inner surface and immediately forms a highly hemocompatible (noncollagenous) contact interface to the blood flow and promotes the formation of a dense and coherent primary fibrin layer as the “guide-rail” for a complete cellular neointima.

On the gelatine coating, the autologous fibrin film remains coherent and stable for long periods, probably indefinitly, when after clinical implantation the cellular healing of the graft remains poor or is absent.

In the absence of endothelium, a stable fibrin flow surface, the nature’s own means of covering a denuded region of the vascular wall, is superior to both the teflon/air flow surface of ePTFE, and the glutaraldehyde-fixed collageneous surface of the umbilical vein biograft.

The microporous flow surface of the experimental ffPUR prosthesis allows the firm attachment of a very thin fibrin film. Even under haemorrheologic disadvantageous conditions (loop-shaped conduit), this fibrin film forms both the athrombogenic interface to the streaming blood for many months and together the guide-rail with excellent anchoring possibilities for neointimal cells.

According to the present study, the patient’s (diseased) vessels in which a prosthesis was implanted, the flow surface consisted of fibrin rather than of endothelium.

In contrast to preclotted blood, the coating can be easily infiltrated by cells which contribute to the healing of the graft.

As a result of improved cellular immigration and penetration the UNI-GRAFT {R} DV prosthesis is better attached to the surrounding tissue and the fibrin layer is better stabilized, thus allowing a more rapid spread of endothelium and neointimal smooth muscle cells.


Flow Surface Vascular Graft Vascular Prosthesis Foreign Body Giant Cell ePTFE Graft 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • C. R. Jerusalem
    • 1
  • F. Hess
    • 1
  1. 1.Dept. of Cell BiologyK.-University of NijmegenNijmegenThe Netherlands

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