An histo-morphological evaluation of ninety surgically excised human umbilical vein grafts

Abstract

Morphological, histological, and scanning electron microscopy examinations were performed on 90 surgically excised human umbilical vein grafts. Most of the explanted grafts were removed because of thrombosis or infection and were removed typically from a patient in the mid 60s and after an average duration of implantation of 11 months. Multiple structural defects were found including deep folds, breaks on the luminal surface, and delamination. These areas as well as anastomotic sites represented potential areas for thrombotic accumulation. A higher incidence of infection was observed in grafts composed of 2 or 3 segments. Bacteria were often found in folds and could be seen invading the wall of the prosthesis. In addition, bacteremic colonization was often seen in noninfected grafts. The late aneurysmal formations were also of particular concern. The biodegradation of the wall and the disruption of the polyester mesh were the probable causes. The second generation Dardik Biograft aimed at reducing these formations. The success of this new processing remains to be evaluated.

A Modified Human Ureter Graft Tanned by a New Crosslinking Agent Polyepoxy Compound for Small Diameter Arterial Substitutions: An Experimental Preliminary Study

“…Although previous reports have demonstrated a vascular xenograft crosslinked with glutaraldehyde in the reconstruction of small caliber biological vessels, such side effects as degeneration, aneurysm formation, and cytotoxicity related to use of glutaraldehyde have remained clinical problems ( 7–9). Recently, however, a polyepoxy compound has been introduced as a new crosslinking agent to overcome the aforementioned disadvantages of glutaraldehyde ( 9–12).…”

“…The glutaraldehyde solution itself is known to have possible genetic side effects. Additionally, the development of ectopic calcification and the tendency to make tissue less flexible, more hydrophobic, and less adaptable to the host tissue, as well as aneurysm formation and cytotoxicity, have all been implicated in the use of glutaraldehyde as a fixative agent ( 7, 8). To overcome these disadvantages, polyepoxy compounds have been introduced as new crosslinking agents and have been found to be more suitable for this purpose than glutaraldehyde ( 9–12).…”

Recent developments of collagen-based materials for medical applications and drug delivery systems

“…Several types of vascular prostheses have been made of collagen. They have further been treated with heparin to create antithrombogenic surfaces [29][30][31][32]. In these studies, collagen tubings were incubated with heparin solutions.…”

Fluoropassivation and gelatin sealing of polyester arterial prostheses to skip preclotting and constrain the chronic inflammatory response

“…The chemical treatment, generally using glutaraldehyde, is a cross‐linking process similar to the tanning procedure used to turn skin into leather 15 . In vivo results of the bioprostheses proved to be less than optimal, forming thrombus, stenoses, and causing disruption of the wall 16, 17. Almost all the chemically modified grafts are now history because of their poor resistance to in vivo degradation 18.…”