The role of circulating cells in the healing of vascular prostheses

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Presentation transcript:

The role of circulating cells in the healing of vascular prostheses Stewart M. Scott, MD, Melissa G. Barth, BSMT, Lee R. Gaddy, BA, Ernest T. Ahl, MD Journal of Vascular Surgery Volume 19, Issue 4, Pages 585-593 (April 1994) DOI: 10.1016/S0741-5214(94)70030-3 Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Metal stent with polyester pledget attached to legs of stent with 6-0 polypropylene sutures. A, Stent shown partially extruded from catheter, which is used to pass stent into aorta from femoral artery. Once in place, stent is extruded by passing smaller catheter through lumen of catheter containing stent. B, Mock demonstration of stent as it would appear in vessel after being extruded. Stent is in 10 mm vascular graft, which has window to visualize stent. C, Another view of stent shows pledget suspended and isolated from luminal surface of graft. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 X-ray film shows stent (arrow) with pledget in dog's abdominal aorta. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3, A-C. Scanning electron microscopy of explanted pledgets Fig. 3, A-C. Scanning electron microscopy of explanted pledgets. A, Flat mononuclear cells beginning to cover surface of woven Dacron pledget implanted in dog's abdominal aorta for 7 days. (Original magnification ×1310.) B, Flat endothelial-like cells on surface of knitted Dacron pledget implanted in dog's inferior vena cava for 7 days. (Original magnification ×1310.) C, Endothelial-like cells covering surface of collagen-coated woven Dacron pledget implanted in thoracic aorta of dog 639 for 31 days. (Original magnification ×655). D-G. Scanning electron microscopy of explanted pledgets. D, Surface of collagen-coated Dacron graft pledget implanted in thoracic aorta of dog 653 for 92 days shows prominent nuclei of endothelial cells. (Original magnification ×600.) E, Flat mononuclear cells cover woven double-velour Dacron pledget implanted in dog 612 for 193 days. (Original magnification ×655.) F, Polytetrafluoroethylene pledget and polypropylene support suture. (Original magnification ×37.4.) G, Polypropylene suture at higher maginification shows no thrombus or cells from pledget. (Original magnification ×150.) Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Dacron polyester pledget explanted after 55 days, methanol-Carnoy fixed, and Paraplast embedded for immunocytochemical analysis. A, Layer of endothelium overlying organized layer of flat, spindle-shaped cells. Fibrin surrounds Dacron fibers, and foreign body giant cells are present. (Hematoxylin and eosin stain. Original magnification ×100.) B, Dark-staining factor VIII – related antigen present in endothelial cells. Capillary (arrow) also stains for antigen. (Original magnification ×200.) C, Section stained for antimacrophage antibody demonstrates macrophages (large arrow) and positively stained endothelial cell (small arrow). (Original magnification ×400.) D, Antimuscle actin in fibroblast-like cells beneath endothelial layer (arrow) indicates layer of smooth muscle cells. (Original magnification ×200.) E, Intense staining of smooth muscle cells with anti-smooth muscle actin. (Original magnification ×100.) F, Antivimentin antibody-stained section shows presence of particles in all cells of mesenchymal origin. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Dacron polyester pledget explanted after 55 days, methanol-Carnoy fixed, and Paraplast embedded for immunocytochemical analysis. A, Layer of endothelium overlying organized layer of flat, spindle-shaped cells. Fibrin surrounds Dacron fibers, and foreign body giant cells are present. (Hematoxylin and eosin stain. Original magnification ×100.) B, Dark-staining factor VIII – related antigen present in endothelial cells. Capillary (arrow) also stains for antigen. (Original magnification ×200.) C, Section stained for antimacrophage antibody demonstrates macrophages (large arrow) and positively stained endothelial cell (small arrow). (Original magnification ×400.) D, Antimuscle actin in fibroblast-like cells beneath endothelial layer (arrow) indicates layer of smooth muscle cells. (Original magnification ×200.) E, Intense staining of smooth muscle cells with anti-smooth muscle actin. (Original magnification ×100.) F, Antivimentin antibody-stained section shows presence of particles in all cells of mesenchymal origin. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Dacron polyester pledget explanted after 55 days, methanol-Carnoy fixed, and Paraplast embedded for immunocytochemical analysis. A, Layer of endothelium overlying organized layer of flat, spindle-shaped cells. Fibrin surrounds Dacron fibers, and foreign body giant cells are present. (Hematoxylin and eosin stain. Original magnification ×100.) B, Dark-staining factor VIII – related antigen present in endothelial cells. Capillary (arrow) also stains for antigen. (Original magnification ×200.) C, Section stained for antimacrophage antibody demonstrates macrophages (large arrow) and positively stained endothelial cell (small arrow). (Original magnification ×400.) D, Antimuscle actin in fibroblast-like cells beneath endothelial layer (arrow) indicates layer of smooth muscle cells. (Original magnification ×200.) E, Intense staining of smooth muscle cells with anti-smooth muscle actin. (Original magnification ×100.) F, Antivimentin antibody-stained section shows presence of particles in all cells of mesenchymal origin. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Dacron polyester pledget explanted after 55 days, methanol-Carnoy fixed, and Paraplast embedded for immunocytochemical analysis. A, Layer of endothelium overlying organized layer of flat, spindle-shaped cells. Fibrin surrounds Dacron fibers, and foreign body giant cells are present. (Hematoxylin and eosin stain. Original magnification ×100.) B, Dark-staining factor VIII – related antigen present in endothelial cells. Capillary (arrow) also stains for antigen. (Original magnification ×200.) C, Section stained for antimacrophage antibody demonstrates macrophages (large arrow) and positively stained endothelial cell (small arrow). (Original magnification ×400.) D, Antimuscle actin in fibroblast-like cells beneath endothelial layer (arrow) indicates layer of smooth muscle cells. (Original magnification ×200.) E, Intense staining of smooth muscle cells with anti-smooth muscle actin. (Original magnification ×100.) F, Antivimentin antibody-stained section shows presence of particles in all cells of mesenchymal origin. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Dacron polyester pledget explanted after 55 days, methanol-Carnoy fixed, and Paraplast embedded for immunocytochemical analysis. A, Layer of endothelium overlying organized layer of flat, spindle-shaped cells. Fibrin surrounds Dacron fibers, and foreign body giant cells are present. (Hematoxylin and eosin stain. Original magnification ×100.) B, Dark-staining factor VIII – related antigen present in endothelial cells. Capillary (arrow) also stains for antigen. (Original magnification ×200.) C, Section stained for antimacrophage antibody demonstrates macrophages (large arrow) and positively stained endothelial cell (small arrow). (Original magnification ×400.) D, Antimuscle actin in fibroblast-like cells beneath endothelial layer (arrow) indicates layer of smooth muscle cells. (Original magnification ×200.) E, Intense staining of smooth muscle cells with anti-smooth muscle actin. (Original magnification ×100.) F, Antivimentin antibody-stained section shows presence of particles in all cells of mesenchymal origin. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Dacron polyester pledget explanted after 55 days, methanol-Carnoy fixed, and Paraplast embedded for immunocytochemical analysis. A, Layer of endothelium overlying organized layer of flat, spindle-shaped cells. Fibrin surrounds Dacron fibers, and foreign body giant cells are present. (Hematoxylin and eosin stain. Original magnification ×100.) B, Dark-staining factor VIII – related antigen present in endothelial cells. Capillary (arrow) also stains for antigen. (Original magnification ×200.) C, Section stained for antimacrophage antibody demonstrates macrophages (large arrow) and positively stained endothelial cell (small arrow). (Original magnification ×400.) D, Antimuscle actin in fibroblast-like cells beneath endothelial layer (arrow) indicates layer of smooth muscle cells. (Original magnification ×200.) E, Intense staining of smooth muscle cells with anti-smooth muscle actin. (Original magnification ×100.) F, Antivimentin antibody-stained section shows presence of particles in all cells of mesenchymal origin. Journal of Vascular Surgery 1994 19, 585-593DOI: (10.1016/S0741-5214(94)70030-3) Copyright © 1994 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions