Polyurethane vascular prostheses decreases neointimal formation compared with expanded polytetrafluoroethylene

M. G. Jeschke, V. Hermanutz, Steven Wolf, G. B. Koveker

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Purpose: Synthetic grafts have been increasingly used for complex vascular reconstructions in patients with limited autologous vein availability. Materials currently in use induce increased stenosis and graft thrombosis compared with autologous vein, especially in smaller vessels. We examined whether grafts constructed of a porous biodegradation-resistant polycarbonate polyurethane (PU) exert better biocompatibility in terms of faster endothelialization and decreased chronic proliferation of intimal cells compared with expanded polytetrafluoroethylene (ePTFE). Methods: PU or ePTFE interposition grafts were implanted into the abdominal aortas of male Sprague-Dawley rats (PU, n = 37; ePTFE, n = 32). Grafts were removed at days 1, 7, 14, 28, and 56 and 6 months and were evaluated by immunohistochemical, electron microscopic, and morphometric techniques. Bromodeoxyuridine (BrdU) was injected at 1 and 24 hours before death to determine cellular proliferation. Endothelial cells and smooth muscle cells were identified with antibodies to von Willebrand factor and α-actin, respectively. Results: The luminal surface of PU grafts took 4 weeks to completely endothelialize, whereas ePTFE grafts took 24 weeks (P < .05). Neointimal cell proliferation was lower in PU grafts compared with ePTFE at 56 days (1.4 ± 0.1 versus 8.6 ± 1.5, P < .001) and at 6 months (0.15 ± 0.002 versus 3.4 ± 0.5, p < .001). Neointimal thickness at 6 months after implantation was 3.2 ± 0.8 μm for PU compared with 10.3 ± 3.1 μm for ePTFE (P < .05). Conclusion: Polycarbonate polyurethane small vascular prostheses promoted faster luminal endothelialization, induced less chronic intimal proliferation, and produced a significantly thinner neointima than ePTFE grafts. These findings suggest that aliphatic-polycarbonate urethanes may offer advantages over standard materials such as ePTFE for vascular graft construction.

Original languageEnglish (US)
Pages (from-to)168-176
Number of pages9
JournalJournal of Vascular Surgery
Volume29
Issue number1
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Fingerprint

Blood Vessel Prosthesis
Polyurethanes
Polytetrafluoroethylene
polycarbonate
Transplants
Tunica Intima
Cell Proliferation
Blood Vessels
Veins
Neointima
Urethane
Abdominal Aorta
von Willebrand Factor
Bromodeoxyuridine
Smooth Muscle Myocytes
Sprague Dawley Rats
Actins
Pathologic Constriction
Thrombosis
Endothelial Cells

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Polyurethane vascular prostheses decreases neointimal formation compared with expanded polytetrafluoroethylene. / Jeschke, M. G.; Hermanutz, V.; Wolf, Steven; Koveker, G. B.

In: Journal of Vascular Surgery, Vol. 29, No. 1, 01.01.1999, p. 168-176.

Research output: Contribution to journalArticle

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abstract = "Purpose: Synthetic grafts have been increasingly used for complex vascular reconstructions in patients with limited autologous vein availability. Materials currently in use induce increased stenosis and graft thrombosis compared with autologous vein, especially in smaller vessels. We examined whether grafts constructed of a porous biodegradation-resistant polycarbonate polyurethane (PU) exert better biocompatibility in terms of faster endothelialization and decreased chronic proliferation of intimal cells compared with expanded polytetrafluoroethylene (ePTFE). Methods: PU or ePTFE interposition grafts were implanted into the abdominal aortas of male Sprague-Dawley rats (PU, n = 37; ePTFE, n = 32). Grafts were removed at days 1, 7, 14, 28, and 56 and 6 months and were evaluated by immunohistochemical, electron microscopic, and morphometric techniques. Bromodeoxyuridine (BrdU) was injected at 1 and 24 hours before death to determine cellular proliferation. Endothelial cells and smooth muscle cells were identified with antibodies to von Willebrand factor and α-actin, respectively. Results: The luminal surface of PU grafts took 4 weeks to completely endothelialize, whereas ePTFE grafts took 24 weeks (P < .05). Neointimal cell proliferation was lower in PU grafts compared with ePTFE at 56 days (1.4 ± 0.1 versus 8.6 ± 1.5, P < .001) and at 6 months (0.15 ± 0.002 versus 3.4 ± 0.5, p < .001). Neointimal thickness at 6 months after implantation was 3.2 ± 0.8 μm for PU compared with 10.3 ± 3.1 μm for ePTFE (P < .05). Conclusion: Polycarbonate polyurethane small vascular prostheses promoted faster luminal endothelialization, induced less chronic intimal proliferation, and produced a significantly thinner neointima than ePTFE grafts. These findings suggest that aliphatic-polycarbonate urethanes may offer advantages over standard materials such as ePTFE for vascular graft construction.",
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