Inflammation and Neovascularization Associated with Clinically Used Vascular Prosthetic Materials

• Published in: Cardiovascular pathology 1999-03, Vol.8 (2), p.63-71
• Main Authors: Salzmann, Dennis L., Kleinert, Leigh B., Berman, Scott S., Williams, Stuart K.
• Format: Article
• Language: English
• Subjects: Adipose Tissue - blood supply; Adipose Tissue - pathology; Adipose Tissue - surgery; Animals; Biocompatible Materials - adverse effects; Blood Vessel Prosthesis - adverse effects; Blood Vessel Prosthesis Implantation; Dermatologic Surgical Procedures; Image Processing, Computer-Assisted; Immunohistochemistry; Inflammation - chemically induced; Inflammation - pathology; Male; Materials Testing; Microscopy, Electron, Scanning; Neovascularization, Pathologic - chemically induced; Neovascularization, Pathologic - pathology; Polyethylene Terephthalates - adverse effects; Polymers - adverse effects; Polytetrafluoroethylene - adverse effects; Rats; Skin - blood supply; Skin - pathology; Wound Healing
• ISSN: 1054-8807; 1879-1336
• DOI: 10.1016/S1054-8807(98)00003-9

This study was designed to evaluate and compare healing characteristics, specifically neovascularization and inflammation, of polymeric vascular graft materials commonly used in clinical applications. Our hypotheses were (i) polymeric materials used in vascular graft manufacture stimulate chronic inflammation and (ii) inflammation and neovascularization of polymeric materials are related. Impra and Gore-Tex ePTFE, Meadox weavenit and woven Dacron, Hemashield microvel and woven Dacron, and Golaski microknit Dacron were implanted as 6-mm diameter disks within rat subcutaneous and adipose tissue. Following 5 weeks of implantation samples were evaluated by histological and immunocytochemical analysis. Sections were stained using hematoxylin and eosin or reacted with ED1 antibody and GS1 lectin to quantify inflammation and neovascularization, respectively. The extent of inflammation and neovascularization were influenced by both tissue site of implantation and polymer characteristics. For subcutaneous implants, inflammation was graded as follows: Meadox weavenit > Hemashield woven > Meadox woven > Gore-Tex ePTFE > Hemashield microvel > Impra ePTFE > Golaski microknit, while only the Golaski microknit neovascularized. Inflammation was graded as follows for adipose implants: Hemashield woven > Hemashield microvel > Meadox weavenit > Meadox woven > Gore-Tex ePTFE > Golaski microknit > Impra ePTFE, while the following order of neovascularization was observed: Impra ePTFE > Gore-Tex ePTFE > Golaski microknit. The degree of inflammation following biomaterial implantation has a profound effect on implant neovascularization. These data suggest an inverse relationship exists between inflammation and neovascularization.