Download PDF
Zentralbl Chir 2005; 130(1): 71-76
DOI: 10.1055/s-2004-836244
Experimentelle Medizin

© Georg Thieme Verlag Stuttgart · New York

Healing Characteristics of a New Silver-Coated, Gelatine Impregnated Vascular Prosthesis in the Porcine Model

Das Einheilungsverhalten einer neuen Silber-beschichteten, Gelatine-imprägnierten Gefäßprothese am SchweinemodellT. Ueberrueck1 , 2 , L. Meyer2 , R. Zippel3 , G. Nestler4 , T. Wahlers1 , I. Gastinger2
  • 1Friedrich-Schiller University, Department of Cardiothoracic and Vascular Surgery, Jena
  • 2Carl-Thiem-Hospital, Department of Surgery, Cottbus
  • 3Hospital Riesa, Department of Surgery, Riesa
  • 4Otto-von-Guericke-University, Department of Surgery, Magdeburg
Further Information

Publication History

Publication Date:
17 February 2005 (online)

Also available at
    Permissions and Reprints

Abstract

Objectives: To investigate the intraluminal and extraluminal healing behaviour of a new metallic silver coated, gelatine impregnated vascular graft. Design: Comparative animal experimental investigation with randomisation of the animals to control and experimental groups. Material and Methods: 24 pigs were assigned to two control and two experimental groups. The prostheses were interposed in the pigs' infrarenal aorta. For the evaluation, macroscopic, histological and immunohistochemical criteria were applied. Results: The macroscopic evaluation after explantation of the prosthesis revealed similar healing characteristics in the control and experimental groups. The microscopic determination of neo-intimal thickness showed no significant differences between the groups; nor did the immunohistochemical investigations show any significant difference between the control group and the silver-coated prosthesis group. Conclusions: No disadvantage of the silver coating in terms of healing and graft patency was found. A possible advantage in terms of the antibacterial effect of the silver coating must be investigated in the clinical setting.

Zusammenfassung

Hintergrund: Untersuchung der intra- und extraluminalen Einheilung einer neuen metallisch Silber-beschichteten, Gelatine-imprägnierten Gefäßprothese. Design: Vergleichende tierexperimentelle Untersuchung mit Randomisierung in Kontroll- und Versuchsgruppen. Material und Methode: 24 Schweine wurden in 2 Kontroll- und 2 Versuchsgruppen randomisiert. Die Gefäßprothesen wurden in die infrarenale Aorta interponiert. Zur Auswertung wurden makroskopische, histologische und immunhistochemische Kriterien verwendet. Ergebnisse: Die makroskopische Beurteilung stellte nach Prothesenexplantation ein vergleichbares Einheilungsverhalten von Kontroll- und Versuchsgruppen dar. Die mikroskopische Neointimadickenbestimmung zeigte keine signifikanten Unterschiede zwischen den Gruppen. In den immunhistochemischen Untersuchungen waren ebenfalls keine signifikanten Unterschiede zwischen der Kontrollgruppe und den silberbeschichteten Gefäßprothesen nachweisbar. Schlussfolgerungen: Ein Nachteil durch die Silberbeschichtung in Bezug auf Einheilung und Offenheit konnte nicht nachgewiesen werden. Ein möglicher Vorteil durch die antibakterielle Wirkung der Silberbeschichtung muss in der klinischen Anwendung untersucht werden.

Key words

Metallic silver-coated vascular prostheses - polyester vascular prostheses - healing characteristics

Schlüsselwörter

Silberbeschichtete Gefäßprothese - Polyestergefäßprothese - Einheilungsverhalten

References

  • 1 Abbott W M, Callow A, Moore W, Rutherford R, Veith F, Weinberg S. Evaluation and performance standards for arterial prostheses.  J Vasc Surg. 1993;  17 746-756
    CrossrefPubMedGoogle Scholar
  • 2 Ao P Y, Hawthorne W J, Vicaretti M, Fletcher J P. Development of intimal hyperplasia in six different vascular prostheses.  Eur J Vasc Endovasc Surg. 2000;  20 241-249
    CrossrefPubMedGoogle Scholar
  • 3 Chalmers R T, Wolfe J H, Cheshire N J, Stansby G, Nicolaides A N, Mansfield A O, Barrett S P. Improved management of infrainguinal bypass graft infection with methicillin-resistant Staphylococcus aureus.  Br J Surg. 1999;  86 1433-1436
    CrossrefPubMedGoogle Scholar
  • 4 De Scheerder I K, Wilczek K L, Verbeken E V, Vandorpe J, Lan P N, Schacht E, De Geest H, Piessens J. Biocompatibility of polymer-coated oversized metallic stents implanted in normal porcine coronary arteries.  Atherosclerosis. 1995;  114 105-114
    CrossrefPubMedGoogle Scholar
  • 5 Goeau-Brissonniere O A, Fabre D, Leflon-Guibout V, Di Centa I, Nicolas-Chanoine M H, Coggia M. Comparison of the resistance to infection of rifampin-bonded gelatin-sealed and silver/collagen-coated polyester prostheses.  J Vasc Surg. 2002;  35 1260-1263
    PubMedGoogle Scholar
  • 6 Gundersen H J, Bendtsen T F, Korbo L, Marcussen N, Moller A, Nielsen K, Nyengaard J R, Pakkenberg B, Sorensen F B, Vesterby A. Some new, simple and efficient stereological methods and their use in pathological research and diagnosis.  APMIS. 1988;  96 379-394
    PubMedGoogle Scholar
  • 7 Hong M K, Kornowski R, Bramwell O, Ragheb A O, Leon M B. Paclitaxel-coated Gianturco-Roubin II (GR II) stents reduce neointimal hyperplasia in a porcine coronary in-stent restenosis model.  Coron Artery Dis. 2001;  12 513-515
    CrossrefPubMedGoogle Scholar
  • 8 Huang B, Marois Y, Roy R, Julien M, Guidoin R. Cellular reaction to the Vascugraft polyesterurethane vascular prosthesis: in vivo studies in rats.  Biomaterials. 1992;  13 209-216
    CrossrefPubMedGoogle Scholar
  • 9 Illingworth B L, Tweden K, Schroeder R F, Cameron J D. In vivo efficacy of silver-coated (Silzone) infection-resistant polyester fabric against a biofilm-producing bacteria, Staphylococcus epidermidis.  J Heart Valve Dis. 1998;  7 524-530
    PubMedGoogle Scholar
  • 10 Jones L, Braithwaite B D, Davies B, Heather B P, Earnshaw J J. Mechanism of late prosthetic vascular graft infection.  Cardiovasc Surg. 1997;  5 486-489
    PubMedGoogle Scholar
  • 11 Mertens R A, O'Hara P J, Hertzer N R, Krajewski L P, Beven E G. Surgical management of infrainguinal arterial prosthetic graft infections: review of a thirty-five-year experience.  J Vasc Surg. 1995;  21 782-790
    PubMedGoogle Scholar
  • 12 Nugent H M, Edelman E R. Endothelial implants provide long-term control of vascular repair in a porcine model of arterial injury.  J Surg Res. 2001;  99 228-234
    CrossrefPubMedGoogle Scholar
  • 13 Qin F, Impeduglia T, Schaffer P, Dardik H. Overexpression of von Willebrand factor is an independent risk factor for pathogenesis of intimal hyperplasia: preliminary studies.  J Vasc Surg. 2003;  37 433-439
    PubMedGoogle Scholar
  • 14 Schierholz J M, Lucas L J, Rump A, Pulverer G. Efficacy of silver-coated medical devices.  J Hosp Infect. 1998;  40 257-262
    CrossrefPubMedGoogle Scholar
  • 15 Tweden K S, Cameron J D, Razzouk A J, Bianco R W, Holmberg W R, Bricault R J, Barry J E, Tobin E. Silver modification of polyethylene terephthalate textiles for antimicrobial protection.  ASAIO J. 1997;  43 M 475-M 481
    PubMedGoogle Scholar
  • 16 Wu M H, Shi Q, Onuki Y, Kouchi Y, Sauvage L R. Histologic observation of continuity of transmural microvessels between the perigraft vessels and flow surface microostia in a porous vascular prosthesis.  Ann Vasc Surg. 1996;  10 11-15
    PubMedGoogle Scholar
  • 17 Xue L, Greisler H P. Biomaterials in the development and future of vascular grafts.  J Vasc Surg. 2003;  37 472-480
    PubMedGoogle Scholar
  • 18 Yee D C, Williams S K, Salzmann D L, Pond G D, Patula V, Berman S S, Roach D J. Stent versus endovascular graft healing characteristics in the porcine iliac artery.  J Vasc Interv Radiol. 1998;  9 609-617
    PubMedGoogle Scholar

Torsten Ueberrueck

Friedrich-Schiller University · Department of Cardiothoracic and Vascular Surgery

Erlanger Allee 101

07747 Jena

Germany

Phone: 00 49/36 41/9 32 29 01

Fax: 00 49/36 41/9 32 29 02

Email: torsten.ueberrueck@med.uni-jena.de

      >