Publication details

Evaluation of a novel vascular graft with a distal bifurcation designed to reduce the development of intimal hyperplasia. Experimental study in a porcine aorta model

Authors

VLACHOVSKÝ Robert STAFFA Robert DVORAK Martin VLASIN Michal HERMANOVÁ Markéta O’BRIEN Thomas MCGLOUGHLIN Timothy

Year of publication 2014
Type Article in Periodical
Magazine / Source Biomedical Papers
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.5507/bp.2013.021
Field Surgery incl. transplantology
Keywords animal model; anastomosis; graft design; distal bifurcation; intimal hyperplasia; experimental study; pig
Description Objective. Abnormal haemodynamics is commonly agreed to be a major contributor to the development of distal anastomotic intimal hyperplasia. A new vascular graft design proposed by computational studies was used to demonstrate its surgical feasibility and to compare it with the conventional graft in a porcine model. Method. The device was used in 12 eight-month-old pigs, six received the new graft and six had a conventional graft. The proximal graft end was implanted into the aorta, the distal graft end was implanted into the iliac artery. The host artery was ligated in order to simulate occlusion. At 20 weeks after surgery the pigs were killed and the device was excised for histological and morphometric analysis. Results. In five experimental grafts the reconstruction was occluded due to thrombosis; only one prosthesis was patent showing a minimum of neointimal hyperplasia. In the control group too only three of the six grafts were patent. A histological analysis revealed, as the cause of occlusion, fibrous tissue overgrowth corresponding in structure to neointimal hyperplasia. Differences in the number of obliterations and in occlusion rates between the profiles of the two groups were evaluated using the median test (P<0.05). The results were not statistically significant. Conclusion. Although mathematical modelling had shown significant haemodynamic benefits of a naturally bifurcated graft, our study did not confirm its superiority over conventionally used prostheses.

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