Thorac Cardiovasc Surg 2010; 58 - MP26
DOI: 10.1055/s-0029-1246683

Novel biodegradable vascular prosthesis: short-term results after carotid artery replacement in the pig

D Mugnai 1, W Mrowczynski 1, S de Valence 2, JC Tille 3, E Khabiri 1, R Gurny 2, A Kalangos 1, M Moeller 2, BH Walpoth 1
  • 1Geneva University Hospital, Department of Surgery, Geneva, Switzerland
  • 2University of Geneva, Pharmaceutics & Biopharmaceutics EPGL, Geneva, Switzerland
  • 3Geneva University Hospital, Department of Pathology, Geneva, Switzerland

Aims: There is a continuous search for shelf-ready small-caliber vascular prostheses. Biodegradable scaffolds, repopulated by recipient's cells regenerating a neo-vessel, can be a suitable option for both adult/pediatric, urgent/elective cardiovascular procedures. We assessed a new biodegradable vascular prosthesis for arterial replacement in the pig.

Methods: Ten anesthetized pigs underwent bilateral carotid artery replacement with biodegradable electrospun Poly(e-caprolactone) (PCL) nanofibre prostheses (4mm-ID; 5cm-long); or expanded-polytetrafluoroethylene(ePTFE) prostheses. Peri-operative anticoagulation was achieved with intravenous heparin (double baseline ACT). Post-operatively, until conclusion of the study at 1-month, animals received aspirin daily. Transit Time Flow (TTF) was measured intra-operatively and at sacrifice. Doppler ultrasound follow-up was performed at 1 and 4 weeks when a selective carotid angiography assessed patency. Graft examination consisted of histology with special stainings, planimetry and SEM.

Results: Surgical handling and haemostasis of the new prostheses was excellent. Patency rate was 78%(7/9) for PCL grafts, compared to 70%(7/10) for ePTFE grafts. TTF and Doppler ultrasound showed no significant changes in flow and velocity or diameter over time in both groups. Both prostheses showed minimal compliance as compared to native carotid artery. Neoendothelialisation was 79% for PCL; 80% for ePTFE grafts. Neointima formation was limited in both grafts. The PCL graft was partially infiltrated from the adventitia by macrophages, myofibroblasts and capilleries with a mild foreign-body reaction and focal thrombus formation.

Conclusions: Biodegradable, electrospun PCL grafts showed good surgical properties, no aneurysm formation and similar short-term patency compared to ePTFE grafts. Rapid, good endothelialisation and cell ingrowth confirms the hypothesis of in vivo vascular tissue engineering.