Endothelial cell seeding is one of the methods commonly used to prepare an antithrombogenic surface for small caliber vascular prostheses. In this study, we investigated the perianastomotic tissue reaction of seeded grafts, using a canine model. Eight dogs were used to harvest endothelial cells (ECs) enzymatically from their external jugular veins, with one dog being excluded because of infection. ECs were cultured and seeded, using a rotation method, onto a small caliber prosthesis woven with ultrafine polyester fibers. Each graft was implanted into the carotid artery of its cell donor dog, with another implanted contralaterally as a non seeded control. Two of seven seeded grafts were patent at 3 months, while all controls were occluded. Histologic examination revealed a continuous lining of ECs in the patent grafts, but thickening of the intima at the anastomoses was also observed. The occluded seeded grafts had organized hard thrombi and thick fibrosis at the perianastomotic area, however, with few thrombi in the midportion. These observations suggest that the investigation of a small caliber prosthesis with the ultimate aim of producing better patency should focus not only on antithrombogenicity of the surface of the lumen, but also on the perianastomotic biologic reaction
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