Proof of fallout endothelialization of impervious Dacron grafts in the aorta and inferior vena cava of the dog Qun Shi, MD, Moses Hong-De Wu, MD, Naoki.

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Presentation transcript:

Proof of fallout endothelialization of impervious Dacron grafts in the aorta and inferior vena cava of the dog Qun Shi, MD, Moses Hong-De Wu, MD, Naoki Hayashida, MD, Arlene R. Wechezak, PhD, Alexander W. Clowes, MD, Lester R. Sauvage, MD Journal of Vascular Surgery Volume 20, Issue 4, Pages 546-557 (October 1994) DOI: 10.1016/0741-5214(94)90279-8 Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A-C, Models for study of fallout healing in DTA, AA, and IVC. D-F, Representative gross specimens for each implant site (histologic findings are given in Fig. 4). Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Cross section of warp-knit Dacron graft made impervious by external application of silicone rubber. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Blockage of pannus and transmural ingrowth allows study at 8 weeks of fallout endothelialization of isolated central Dacron limb of DTA prosthesis made impervious by external application of silicone rubber. A, Limited pannus growth from host aorta onto PTFE surface. No transmural ingrowth from perigraft sources. LM. (Original magnification ×50.) B, Representative section of PTFE segment beyond pannus zone showing absence of endothelium on fibrin-covered flow surface. LM. (Original magnification ×125.) C, Section from isolated, impervious central Dacron limb shows no ingrowth and presence of endothelial-like cells covering multiple layers of elongated cells reactive to α-actin staining in Fig. 5,D. LM. (Hematoxylin-eosin stain; original magnification ×50). Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Findings from three implant sites. A-C, LM. (Silver nitrate stain; original magnification ×70.) D-F, LM. (Original magnification ×500.) G, SEM. (Original magnification ×1000.) H, SEM. (Original magnification ×500.) I, SEM. (Original magnification ×3000.) J-L, TEM. (Original magnification ×4000.) M,N, FVIII/vWF (Häutchen technique). (Original magnification ×500.) O, FVIII/vWF (Häutchen technique). (Original magnification ×1000.) Implant periods of DTA were 8 weeks for A, D, G, and J, and 4 weeks for M. All AA and IVC grafts were implanted for 4 weeks. D through O were stained with hematoxylin-eosin. Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Arrows point to endothelial-like single cells among white cells on flow surface of 4-week DTA specimen. (SEM, original magnification ×500.) Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Three types of substrates found under single layers of endothelial-like cells in isolated, permanently impervious grafts. A, Eight-week specimen shows proteinaceous substrate. B, Eight-week specimen shows superficial substrate composed of macrophages and leukocytes with proteinaceous substrate below. C, 12-week specimen shows substrate containing cells shown to be positive to α-actin staining in D. A-C, Light microscopy. (Hematoxylin-eosin stain; original magnification ×500.) Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Three types of substrates found under single layers of endothelial-like cells in isolated, permanently impervious grafts. A, Eight-week specimen shows proteinaceous substrate. B, Eight-week specimen shows superficial substrate composed of macrophages and leukocytes with proteinaceous substrate below. C, 12-week specimen shows substrate containing cells shown to be positive to α-actin staining in D. A-C, Light microscopy. (Hematoxylin-eosin stain; original magnification ×500.) Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Three types of substrates found under single layers of endothelial-like cells in isolated, permanently impervious grafts. A, Eight-week specimen shows proteinaceous substrate. B, Eight-week specimen shows superficial substrate composed of macrophages and leukocytes with proteinaceous substrate below. C, 12-week specimen shows substrate containing cells shown to be positive to α-actin staining in D. A-C, Light microscopy. (Hematoxylin-eosin stain; original magnification ×500.) Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Three types of substrates found under single layers of endothelial-like cells in isolated, permanently impervious grafts. A, Eight-week specimen shows proteinaceous substrate. B, Eight-week specimen shows superficial substrate composed of macrophages and leukocytes with proteinaceous substrate below. C, 12-week specimen shows substrate containing cells shown to be positive to α-actin staining in D. A-C, Light microscopy. (Hematoxylin-eosin stain; original magnification ×500.) Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Microvessels (arrows) in neointima of coated DTA graft at 8 weeks. Light microscopy. (Original magnification ×125.) Journal of Vascular Surgery 1994 20, 546-557DOI: (10.1016/0741-5214(94)90279-8) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions