Development of a small-caliber vascular graft with antithrombogenicity induced by extreme hydrophilicity.
A small-caliber vascular graft with an excellent patency rate, which has satisfactory antithrombogenicity due to high hydrophilicity, has been developed. It is hemostatic at the anastomotic site and has an affinity for endothelial-like cells, smooth musclelike cells, and fibroblasts. Fresh carotid artery with an ID of 2.5 to 3.0 mm was obtained from a dog and sonicated to induce destruction of the cell components. It was then cross-linked with a hydrophilic polyepoxy compound. As controls, glutaraldehyde (GA) treated grafts were prepared. Twenty-one dogs were used, 14 for the new graft and the other 7 as controls. A segment of the graft, 6 cm in length, was implanted into the carotid artery. Sodium heparin was given during surgery, but no anticoagulant was used thereafter. The compliance of the new graft was similar to that of the native artery. No excessive bleeding was noticed at the anastomotic sites. The patency rate was 70.8% during the longest observation period of 145 days, but was only 10% in the controls. Microscopic observation revealed that by the seventh day after implantation, endothelial-like cells had appeared near the anastomotic lines on the inner surface of the new graft; smooth musclelike cells were observed on the 38th day after implantation. From these results, there is a good possibility that this new graft, with its many advantages, may be used clinically.