Small Diameter Vascular Prostheses with Incorporated Bioabsorbable Matrices

The authors have designed small diameter vascular prostheses with incorporated matrices that can be absorbed into a growing anastomotic neointima. First, a gelatin-heparin complex was coated on the inner surface of tubular ultrafine polyester fabrics presealed with heat denatured albumin. Second, to control the bioabsorption rate, the prepared grafts were cross-linked with polyepoxy compounds for 3 days (Group I; n = 14) or 5 days (Group II; n = 4). These grafts, 3 mm in diameter and 4 cm long, replaced the carotid arteries of nine mongrel dogs weighing 9.5-14 kg. Six of eight (75%) grafts in Group I were patent when the animals were killed 4 weeks after surgery. Doppler sound examination revealed that the remaining six were patent for 16 weeks. In Group II, three of four (75%) grafts were patent when the animals were killed 8 weeks after surgery. In both groups, scanning electron microscopic study showed neither platelet aggregation nor fibrin formation on the midportion. However, these two groups significantly differed in histology. In Group I, thin anastomotic neointima advanced over the mostly absorbed gelatin-heparin complex layer. Connective tissue was well formed around the polyester scaffold. In contrast, thick neointima advanced over the gelatin-heparin complex layer that still remained on the luminal surface in Group II. These results suggest that the gelatin-heparin complex, when cross-linked adequately, could simultaneously function as a temporary antithrombogenic surface and as an excellent substructure of an anastomotic neointima.