Preliminary comparative study of small amplitude helical and conventional ePTFE arteriovenous shunts in pigs.
J R Soc Interface
; 2(3): 261-6, 2005 Jun 22.
Article
em En
| MEDLINE
| ID: mdl-16849184
ABSTRACT
Intimal hyperplasia (IH), which causes occlusion of arterial bypass grafts and arteriovenous (A-V) shunts, develops preferentially in low wall shear, or stagnation, regions. Arterial geometry is commonly three-dimensional, generating swirling flows, the characteristics of which include in-plane mixing and inhibition of stagnation. Clinical arterial bypass grafts are commonly two-dimensional, favouring extremes of wall shear. We have developed small amplitude helical technology (SwirlGraft) devices and shown them to generate physiological-type swirling flows. Expanded polytetrafluorethylene (ePTFE) grafts, although widely used as A-V shunts for renal dialysis access, are prone to thrombosis and IH. In a small preliminary study in pigs, we have implanted SwirlGraft ePTFE carotid artery-to-jugular vein shunts on one side and conventional ePTFE carotid artery-to-jugular vein shunts contralaterally. There was consistently less thrombosis and IH in the SwirlGraft than conventional shunts. At eight weeks (two animals), the differences were marked, with virtually no disease in the SwirlGraft devices and occlusion of the conventional grafts by thrombosis and IH. The study had limitations, but the lesser pathology in the SwirlGraft devices is likely to have resulted from their geometry and the associated swirling flow. The results could have implications for vascular biology and prolongation of the patency of arterial bypass grafts and A-V shunts.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Politetrafluoretileno
/
Derivação Arteriovenosa Cirúrgica
Tipo de estudo:
Prognostic_studies
Limite:
Animals
Idioma:
En
Revista:
J R Soc Interface
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Reino Unido