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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 carotid-femoral 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.

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      References

        • Berger K
        • Sauvage LR
        • Rao AM
        • Wood SJ
        Healing of arterial prostheses in man: its incompleteness.
        Ann Surg. 1972; 175: 118-127
        • Sauvage LR
        • Berger KE
        • Wood SJ
        • Yates Jr, SG
        • Smith JC
        • Mansfield PB
        Interspecies healing of porous arterial prostheses; observation, 1960 to 1974.
        Arch Surg. 1974; 109: 698-705
        • 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
        • Didisheim P
        Species selection for vascular graft evaluation.
        in: Kambic HE Kantrowitz A Sung P Vascular Graft Update: Safety and Performance. American Society for Testing and Materials, Philadelphia1986: 174
        • Yates SG
        • Barros D'Sa AAB
        • Berger K
        • Fernandez LG
        • Wood SJ
        • Rittenhouse EA
        • Davis CC
        • Mansfield PB
        • Sauvage LR
        The preclotting of porous arterial prostheses.
        Ann Surg. 1978; 188: 611-622
        • Sauvage LR
        • Berger K
        • Beilin LB
        • Smith JC
        • Wood SJ
        • Mansfield PB
        Presence of endothelium in an axillary-femoral graft of knitted Dacron with an external velour surface.
        Ann Surg. 1975; 152: 749-753
        • Mathisen SR
        • WU H-D
        • Sauvage LR
        • Usui Y
        • Walker MW
        An experimental study of eight current arterial prostheses.
        J Vasc Surg. 1986; 4: 33-41
        • Sauvage LR
        • Berger K
        • Wood SJ
        • Nakagawa Y
        • Mansfield PB
        An external velour surface for porous arterial prostheses.
        Surgery. 1971; 70: 940-953