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4 . 2021

The value of elasticity and thrombogenicity in the process of integration of synthetic arterial vascular prosthesis in abdominal aorta (experimental study)

Abstract

Aim - to investigate the influence of biomechanical properties and thrombogenicity at the integration of a new synthetic vascular prosthesis with elasticity into the infrarenal aorta.

Material and methods. The thrombogenicity of used synthetic materials - polycaprolactone (PCL), polyurethane (PU), and a mixture of synthetic rubber FKM-26 with fluoroplastic F-26 (FKM-26 + F-26) - was assessed by the area of sample surface coverage with platelets during perfusion with native pig blood. Samples of vascular prostheses made from the listed materials by electrospinning were implanted into the abdominal aorta of pigs. A standard expanded polytetrafluoroethylene (e-PTFE) prostheses were used as a control. The patency and compliance of the prostheses were assessed according to the data of aortography on the 3rd and 30th days after implantation. The condition of the prosthesis capsules was assessed according to the data of histological and immunohistochemical studies.

Results. The material FKM-26 + F-26 has shown the most thrombogenic properties, while only this material makes it possible to manufacture a vascular prosthesis with sufficient elastic properties similar to that of a biological aorta. Vascular grafts made of aortography were either rigid (PCL, PTFE) or lacked elasticity (PU). Therefore, upon implantation into the abdominal aorta, pulsations of the PCL and e-PTFE prostheses were completely absent; on the PU prosthesis, pulsations persisted only for the first three days, and on the FKM-26 + F-26 prosthesis, pulsations persisted for 30 days. As a result, for this prosthesis on the 30th day, the degree of aortic remodeling was minimal; the connective tissue capsule had the greatest number of smooth muscle cells and did not demonstrate the presence of chronic inflammation. Smooth muscle cells in the inner capsule were arranged in layers and oriented along or across the vessel.

Conclusion. When an elastic vascular prosthesis is implanted into the abdominal aorta of a pig, a higher level of integration into biological tissues is shown, despite the relatively high rates of thrombogenicity of the material. Signs of cell differentiation were noted in the prosthesis capsule.

Keywords:elasticity, vascular prosthesis, abdominal aorta, pulsation, thrombogenicity

Funding. This work was carried out with the financial support of the Russian Science Foundation grant No. 16-15-00109. 
Conflict of interest. The authors declare no conflict of interest.
For citation: Tsygankov Yu.M., Serov R.A., Khugaev G.A., Tevosov D.R., Zhorzholiani Sh.T., Agafonov A.V., Gorodkov A.Yu., Bockeria L.A. The value of elasticity and thrombogenicity in the process of integration of synthetic arterial vascular prosthesis in abdominal aorta (experimental study). Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (4): 39-47. DOI: https://doi.org/10.33029/2308-1198-2021-9-4-39-47 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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