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ASAIO J ; 61(5): 596-604, 2015.
Article in English | MEDLINE | ID: mdl-26098175

ABSTRACT

Small intestinal submucosa grafts for vascular regeneration have produced variable patency (0-100%) that has been concurrent with variability in fabrication techniques. We hypothesized that 1) preservation (P) or removal (R) of the stratum compactum layer of the intestine and 2) a dehydrated (D) or hydrated (H) state of the graft, affect early patency and tissue regeneration. We combined both parameters through a 2(2) factorial experimental design into four groups (PD, RD, PH, RH), and compared them in an in vivo early response predictive model (swine, ID 4.5 mm, 7d, n = 4). Patency, thrombogenicity, vascularization, fibroblast infiltration, macrophage polarization profile, endothelialization, and biaxial mechanics were assessed. PD grafts remained patent (4/4) but had scarce vascularization and fibroblast infiltration. RD and RH had extensive vascularization and fibroblast infiltration, however, RD had sustained patency (4/4) and the highest number of regeneration-associated phenotype macrophages (M2), whereas RH had lower patency (3/4) and less M2 macrophages. PH had a modest cellular infiltration, but the lowest patency (2/4) and a dominant adverse macrophage phenotype. Elasticity of R grafts evolved toward that of native carotids (particularly RD), while P grafts kept their initial stiffness. We concluded that fabrication parameters drastically affected early patency and regeneration, with RD providing the best results.


Subject(s)
Blood Vessel Prosthesis , Blood Vessels/physiology , Carotid Arteries/physiology , Jejunum/physiology , Regeneration , Vascular Patency , Animals , Bioprosthesis , Carotid Arteries/surgery , Graft Occlusion, Vascular , Intestinal Mucosa/physiology , Intestinal Mucosa/transplantation , Jejunum/transplantation , Models, Animal , Swine
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