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1、EurJVascEndovascSurg32,418e424(2006)doi:10.1016/j.ejvs.2006.03.002,availableonlineathttp://www.sciencedirect.comonPEG-hirudin/iloprostCoatingofSmallDiameterePTFEGraftsEffectivelyPreventsPseudointimaandIntimalHyperplasiaDevelopmentM.Heise,1*G.Schmidmaier,2I.Husmann,1C.Heidenhain,1J.Schmidt
2、,111P.NeuhausandU.Settmacher1Charite´,UniversityMedicine,DepartmentofGeneralSurgery,and2Charite´,CampusVirchowKlinikum,CenterforMusculoskeletalSurgery,AugustenburgerPlatz1,D-13353Berlin,GermanyObjectives.SmalldiameterPTFEgraftsarepronetothrombosisandintimalhyperplasiadevelopment.Heparingr
3、aftcoatinghasbeneficialeffectsbutalsopotentialdrawbacks.ThepurposeofthisstudywastoevaluatetheexperimentalefficacyofPEG-hirudin/iloprostcoatedsmallcaliberPTFEgrafts.Methods.Thirty-sixfemoro-poplitealePTFEgrafts(expandedpolytetrafluoroethylene,diameter4mm)wereinsertedinto18pigs.Graftswererando
4、misedindividuallyforeachlegandgroupedfor3groups.GroupIconsistedofnativeePTFEgrafts,groupIIweregraftscoatedwithapolylactidepolymer(PLA)withoutdrugsandgroupIIIgraftswerecoatedwithPLAcontainingapolyethyleneglycol(PEG)-hirudin/iloprostcombination.Thefollow-upperiodwas6weeks.Patencyrateswereca
5、lculatedanddevelopmentofpseudointimainsidethegraftswasnoted.Thicknessofintimalhyperplasiaatthedistalanastomoseswasmeasuredusinglightmicroscopy.Results.PatencyratesforgroupIwere6/9(67%),forgroupII9/10(90%)and12/12(100%)forgroupIII.IngroupsIandIItherewasasignificantreductionofbloodflowproxima
6、ltothegraftatgraftharvest,to2912and2820ml/minrespectively(bothp<0.01versuspreoperativevalue),whilstingroupIIIbloodflow,9921ml/min,remainedatthepre-operativelevel.SubtotalstenosisduetodevelopmentofpseudointimawasnotedineachofthenativeandPLAcoatedgraftsbutnotingroupIIIgrafts.Intimalhyperp
7、lasiaatthedistalanastomosiswaslowestingroupIII.Conclusions.ThePEG-hirudin/iloprostcoatingofePTFEprostheseseffectivelyreducedpseudointimaandintimalhyper-plasiadevelopmentandledtosuperiorgraftpatency.Keywords:Intimalhyperplasia;Peripheralgrafts;Antithromboticcoating;H
