Pilot Study of the Efficacy of Extracellular Matrix Arterio-Venous Bypass Grafts in a Sheep (Ovis aries) Model
Final rept. 17 Jan-27 Dec 2013
DAVID GRANT USAF MEDICAL CENTER TRAVIS AFB CA 60TH MEDICAL GROUP
Pagination or Media Count:
Objective The purpose of this study was to compare early patency and histology of Cormatrix small intestine submucosa arteriovenous fistula grafts in sheep. Methods Three crossbred sheep were anesthetized, instrumented, and had a 7 cm fistula created between the carotid artery and jugular vein through a midline neck incision. The fistula was created with CorMatrix extracellular matrix. The wounds were closed and the animals recovered. Lovenox was administered starting post-operatively daily for the remainder of the experiment. Duplex ultrasonography was conducted at 1 and 6 weeks, followed by thorough necropsy and histologic evaluation of the fistulas using hematoxylin and eosin and Massons Trichrome stains. Results Following surgery, two animals had uncomplicated courses without clinical evidence of thrombosis or wound complication. The third animal succumbed from graft failure secondary to a postoperative seroma and wound infection. Duplex examinations revealed patent fistulas with normal vessel diameters, flow velocities, and spectral patterns. Upon post mortem, there was a lack of perivascular inflammation and tissue reaction. Histologic assessment confirmed patency without evidence of thrombosis or inflammatory infiltration. ECM was well populated with cells and near complete luminal endothelial cell coverage was present by four weeks. Conclusion In this pilot study, the Cormatrix extracellular matrix performed well in a sheep A-V fistula graft model.
- Anatomy and Physiology
- Medicine and Medical Research