H. Urayama et al., AN IMMUNOHISTOCHEMICAL ANALYSIS OF IMPLANTED WOVEN DACRON AND EXPANDED POLYTETRAFLUOROETHYLENE GRAFTS IN HUMANS, Artificial organs, 20(1), 1996, pp. 24-29
An immunohistochemical analysis was performed to clarify the healing p
rocess in implanted vascular grafts in human. Eight woven Dacron graft
s and 6 expanded polytetrafluoroethylene grafts were obtained followin
g redo surgery, limb amputation, and autopsy. The implantation periods
ranged from 5 days to 148 months. The antibodies used for the analysi
s were specific to a-actin (smooth muscle cells), macrophages, von Wil
lebrand factor (endothelial cells), fibrin, elastin, collagen types 1-
5, CD3 (T cells), and CD20 (B cells). At 5 and 24 days after implantat
ion, thrombi containing red blood cells and fibrin covered the anastom
otic lines and some of the luminal surfaces of the grafts. Macrophages
were scattered throughout the thrombi. At 11-148 months after implant
ation, either a single layer of endothelial cells or a thin layer of f
ibrin covered the anastomotic segments of the grafts, and smooth muscl
e cells and collagen fibers were seen forming anastomotic intimal hype
rplasia (AIH). The AIH in the grafts at 94 and 148 months after implan
tation was almost the same thickness and length as that in the grafts
at 11-36 months after implantation. Apart from the anastomotic segment
s, a connective tissue matrix containing collagen fibers covered the l
uminal surfaces, and some thrombi were noted. Most of the collagen pre
sent was type 3, in addition to some type 1, 4, and 5 collagen. No typ
e 2 collagen was noted. Some elastin was also detected in the AIH but
not in the midportion of the grafts. Some macrophages and T cells were
noted in the perigraft tissues.