Comparison of the Neointima Inhibition Between Paclitaxel- and Sirolimus-Eluting Expanded Polytetrafluoroethylene Hemodialysis Grafts in a Porcine Model

Abstract

Neointimal hyperplasia causes vascular access dysfunction in hemodialysis patients with synthetic arteriovenous (AV) grafts. Several studies have reported that paclitaxel-or sirolimus-eluting AV grafts inhibit neointimal hyperplasia and display lower rates of stenosis compared with control grafts. However, there have been few comparative studies of the efficacy of paclitaxel-and sirolimus-eluting grafts. We compared the neointimal hyperplasia of paclitaxel-and sirolimus-eluting grafts. AV grafts were implanted laterally between the common carotid artery and the external jugular vein in 12 female Landrace pigs. The animals were sacrificed six weeks after surgery. The neointimal hyperplasia at the anastomosis sites of the grafts was quantified using the ratio of the intragraft hyperplasia to the graft area (H/G ratio) at the graft-vessel interface.

Paclitaxel coating on the terminal portion of hemodialysis grafts effectively suppresses neointimal hyperplasia in a porcine model

“…4 We have demonstrated previously that paclitaxel coated onto an expanded polytetrafluoroethylene (ePTFE) graft markedly reduced venous neointimal hyperplasia in a pig model. [5][6][7][8][9] Because 50% to 70% of vascular stenoses occur within 3 cm of a venous anastomosis, 10 we coated paclitaxel onto only the terminal parts of the ePTFE grafts to evaluate the effects of direct application near each anastomosis site.…”