Quantitative analysis of neovascularization of different PTFE-implants.

The process of neovascularization was analyzed in vivo in different expanded polytetrafluoroethylene (e-PTFE) implants which are frequently used in cardio-thoracic and vascular surgery. We have used the model of the hamster dorsal skinfold chamber which allows quantitative analysis of the microcirculation by means of intravital fluorescence microscopy. Pieces of approximately 1 mm2 of the cardiovascular patch (CVP, fibril length: 30 microns; n = 21), surgical membrane (SM, fibril length: 1 micron; n = 16), and soft tissue patch (STP, fibril length: 22 microns; n = 12) were implanted into the skinfold chambers. On day 10 after implantation, the functional density of newly formed microvessels was significantly (P less than 0.05) higher in CVP (145.0 +/- 10.9 cm-1) as compared to SM (688 +/- 13.9 cm-1) and STP (86.9 +/- 21.2 cm-1). In addition, CVP revealed a larger zone of neovascularization (311.6 +/- 19.4 microns) and the tightest integration (dynamic breaking strength: 17.9 +/- 3.0 cN/mm2) into the perigraft tissue, while SM demonstrated only few microvessels and no integration (6.0 +/- 1.9 cN/mm2) into the perigraft. None of the three different PTFE-implants revealed transmural ingrowth of capillaries. The internodal distance of PTFE implants seems to be the most important factor for neovascularization. Surgical membrane used for the replacement of passive biological membranes demonstrated, as is its purpose, little neovascularization and no integration into the perigraft tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  N. Werthessen,et al.  The development of the pseudointima lining fabric grafts of the aorta. , 1962, British journal of experimental pathology.

[2]  A. Wesolow The healing of arterial prostheses--the state of the art. , 1982, The Thoracic and cardiovascular surgeon.

[3]  D. Frösch,et al.  New techniques of analyzing the healing process of artificial vascular grafts, transmural vascularization, and endothelialization , 1989, Research in experimental medicine. Zeitschrift fur die gesamte experimentelle Medizin einschliesslich experimenteller Chirurgie.

[4]  J. Corson,et al.  Clinical and experimental evaluation of aortic polytetrafluoroethylene grafts for aneurysm replacement. , 1988, Archives of surgery.

[5]  A. Evan,et al.  Endothelial seeding of Dacron and polytetrafluoroethylene grafts: the cellular events of healing. , 1984, Surgery.

[6]  A. Gown,et al.  Mechanisms of arterial graft failure. 1. Role of cellular proliferation in early healing of PTFE prostheses. , 1985, The American journal of pathology.

[7]  G. Picha,et al.  Expanded Polytetrafluoroethylene as a Microvascular Graft: A Study of Four Fibril Lengths , 1985, Plastic and reconstructive surgery.

[8]  K. Messmer,et al.  Technical report—a new chamber technique for microvascular studies in unanesthetized hamsters , 1980, Research in experimental medicine. Zeitschrift fur die gesamte experimentelle Medizin einschliesslich experimenteller Chirurgie.

[9]  C. Fischer,et al.  Experimental study of the influence of porosity on development of neointima in Gore-Tex grafts: a method to increase long-term patency rate. , 1981, The American surgeon.

[10]  R. Bradham The importance of porosity in vascular prostheses , 1960 .

[11]  A. Callow Current status of vascular grafts. , 1982, The Surgical clinics of North America.

[12]  M. Reidy,et al.  Mechanisms of arterial graft healing. Rapid transmural capillary ingrowth provides a source of intimal endothelium and smooth muscle in porous PTFE prostheses. , 1986, The American journal of pathology.