Matching the Diameter of ePTFE Bypass Prosthesis with a Native Artery Improves NeoendothelializationCikirikcioglu M. · Pektok E. · Cikirikcioglu Y.B. · Osorio-da Cruz S. · Tille J.-C. · Kalangos A. · Walpoth B.H.
Departments of aCardiovascular Surgery and bClinical Pathology, University Hospital of Geneva, Geneva, Switzerland
Background and Aim: The undersizing of the bypass graft diameter compared to native artery changes blood flow characteristics and velocity which may affect conduit neo-endothelialization, intimal hyperplasia reaction and patency. The aim of this study was to evaluate conduit neoendothelialization, intimal hyperplasia reaction and patency results between undersized and matched ePTFE grafts. Material and Methods: In 16 male Sprague-Dawley rats, undersized (1-mm internal diameter) and matched (2-mm internal diameter) ePTFE grafts were anastomosed end-to-end in the infrarenal abdominal aorta. Blood flow volume per minute was measured and wall shear stress was calculated for each group. After 3 weeks of follow-up, angiography was performed via the left carotid artery just before sacrifice. Conduit neoendothelialization and intimal hyperplasia reaction were measured by computer-assisted morphometry. Results: Wall shear stress was 8 times higher for the undersized group (840.56 vs. 105.07 mPa). Three weeks after implantation, conduit neoendothelialization was better in matched grafts compared to undersized grafts (441 vs. 574 µm, p = 0.008). Intimal hyperplasia reaction was similar for both groups (8.7 vs. 6.7 µm2/µm for undersized and matched grafts, respectively). Patency rate was 7/8 for undersized and 8/8 for matched ePTFE grafts. Conclusion: Although the graft patency and the intimal hyperplasia reaction were not different between the two groups after 3 weeks, matched grafts had a significantly better endothelialization compared to undersized grafts. This short-term beneficial effect may influence long-term patency results.
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