Autologous fibrin-coated small-caliber vascular prostheses improve antithrombogenicity by reducing immunologic response Tomomi Hasegawa, MD, PhD, Kenji.

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Presentation transcript:

Autologous fibrin-coated small-caliber vascular prostheses improve antithrombogenicity by reducing immunologic response Tomomi Hasegawa, MD, PhD, Kenji Okada, MD, PhD, Yoshihito Takano, Yoshiaki Hiraishi, Yutaka Okita, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 133, Issue 5, Pages 1268-1276.e1 (May 2007) DOI: 10.1016/j.jtcvs.2006.12.049 Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Immunohistochemistry. (Left) Autologous fibrin-coated vascular prostheses (A-graft). (Right) Xenologous fibrin-coated vascular prostheses (X-graft). A, B, ICAM-1; C, D, VCAM-1; E, F, NFκB (original magnifications ×20); G, H, CD45 (original magnifications ×40). Note the decrease in I-CAM-1, VCAM-1, NFκB, and CD45 expression in A-grafts. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Neointimal hyperplasia at anastomosis site. HE stain (original magnification ×20). A, Autologous fibrin-coated vascular prostheses. B, Xenologous fibrin-coated vascular prostheses. Note the significant decrease in neointimal thickness (arrows) in A-grafts. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Platelet deposition. Platelet deposition in autologous fibrin-coated vascular prostheses was significantly less than that in xenologous fibrin-coated vascular prostheses until postoperative day 30. Values are given as mean ± SD. *P < .05. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Serum levels of IgM and IgG. Serial changes of serum IgM and IgG levels in autologous fibrin-coated vascular prostheses (group IIa) were significantly less than those in xenologous fibrin-coated vascular prostheses (group IIx). Values are given as mean ± SD. *P < .05 (ANOVA) in IgG; **P < .05 (ANOVA) in IgM. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Serum levels of tPA/PAI-1 ratio. The tPA/PAI-1 ratio in autologous fibrin-coated vascular prostheses (group IIa) was significantly less than those in xenologous fibrin-coated vascular prostheses (group IIx). Values are given as mean ± SD. *P < .05 (ANOVA). The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Correlations of serum IgG level and tPA/PAI-1 ratio with platelet deposition. Serum IgG level and tPA/PAI-1 ratio correlated significantly with platelet deposition in both grafts (P < .0001, respectively). The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Scanning electron micrographs of the luminal surface on postoperative day 10 (original magnification ×2500). A, Autologous fibrin-coated vascular prostheses. B, Xenologous fibrin-coated vascular prostheses. Activated platelets were adhered to and formed aggregates on the luminal surface in both grafts. The platelet adhesion in A-grafts was less than that in X-grafts. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1268-1276.e1DOI: (10.1016/j.jtcvs.2006.12.049) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions