ENHANCED PATENCY OF SMALL-DIAMETER, EXTERNALLY SUPPORTED DACRON ILIOFEMORAL GRAFTS SEEDED WITH ENDOTHELIAL-CELLS

Abstract

Adults foxhounds (14) underwent bilateral iliofemoral bypasses with externally supported, knitted Dacron grafts measuring 4 mm in internal diameter and 10 cm in length. These conduits were preclotted with 10 ml of blood mixed with 0.5 ml of culture medium. Autologous endothelial cells, enzymatically derived from external jugular veins, were added to blood and medium used to preclot 1 graft in each dog. The other, unseeded graft served as a control. Grafts were anastomosed, end to end, to the iliac and femoral arteries. All dogs received dipyridamole, 50 mg twice a day for 4 days preoperatively, and aspirin, 5 grains 4 times a day for 1 day preoperatively. Both drugs were continued 14 days after operation. Grafts were removed from 3 dogs at 2 and 4 wk and from 4 dogs at 8 and 16 wk. All grafts were patent at 2 wk during drug administration. Cumulative patency rates beyond 2 wk were 73% in 11 seeded grafts and 27% in 11 control grafts, a statistically significant difference (P = 0.03). Seeded grafts were completely surfaced with a monolayer of endothelium between 2 and 4 wk. Small-graft patency appeared related to evolution of endothelial surfaces, the development of which was clearly facilitated by seeding with autologous endothelium.