Clinical long-term results of vascular prosthesis sealed with fragmented autologous adipose tissue

Tissue engineering can improve the former limitations of artificial organs. This article reports the long-term clinical results of grafts constructed with fragmented autologous adipose tissue. We did a retrospective analysis of a series of 53 patients with lower leg ischemia that received 69 fragmen ted adipose tissue (FAT) grafts implantation at our institution. The mean f ollow-up period was 36.0 months. After 1, 2, 3. and 5 years, the primary po tency sates were 85.3, 83.3, 73.8, and 67.7%, respectively. The lumen of oc cluded areas not only at anastomotic sites but also in areas far from the a nastomotic sites was occupied by a thickened neointima, which had a great n umber of capillary blood vessels, elastic laminae, smooth muscle cells, fib roblasts, and collagen fibers. This type of intimal hyperplasia was a chara cteristic finding in the FAT grafts. From the results of this clinical tria l, we conclude that the FAT grafts are acceptable as vascular prostheses fo r ischemic lower extremities. The intimal hyperplasia at sites far from the anastomotic lines suggested the possibility of neointima formation through out the luminal surface of the grafts.