A new vascular substitute: femoral artery angioplasty in dogs using sugarcane biopolymer membrane patch - hemodynamic and histopathologic evaluation

• Autor(es):

  Marques, Sílvio Romero de Barros (Universidade Federal de Pernambuco. Centro de Ciências da Saúde);

  Lins, Esdras Marques (UFPE. CCS. Departamento de Cirurgia);

  Aguiar, José Lamartine de Andrade (UFPE. CCS. Departamento de Cirurgia);

  Albuquerque, Maria Cláudia Sodré (UFPE. CCS. Departamento de Cirurgia);

  Rossiter, Renata de Oliveira (UFPE. Hospital das Clínicas);

  Montenegro, Luciano Tavares (UFPE. CCS. Departamento de Patologia);

  Vieira, Roberto José (UFPE. CCS. Departamento de Patologia).

• Fonte:

  Jornal Vascular Brasileiro; volume 6, número 4, páginas 309-315. Dezembro 2007.

• Assuntos:

  Vascular prosthesis;

  vascular prosthesis implantation;

  bioprosthesis, sugarcane.

• Resumo:

  BACKGROUND: Achievement of an ideal arterial substitute to be used in the reconstruction of small- and medium-caliber arteries is still the main objective of most scientific research studies developed in the area of vascular substitutes. Sugarcane biopolymer membrane could be extremely useful to perform vascular reconstruction in arteries with diameter smaller than 4 mm, allowing treatment of diseases that affect millions of people in Brazil and worldwide. OBJECTIVE: To evaluate the hemodynamic and histopathologic behavior of sugarcane biopolymer membrane when used as a patch in femoral artery angioplasty in dogs. METHOD: Eight adult mongrel dogs, under general anesthesia, underwent percutaneous Doppler velocimetry of the left and right femoral arteries for preoperative control at the Health Sciences Center Experimental Research Laboratory of Universidade Federal de Pernambuco. After being disinfected, the dogs underwent femoral artery patch angioplasty using a sugarcane membrane biopolymer patch on the left side and an expanded PTFE (e-PTFE) patch on the right side. The dogs underwent daily clinical evaluation for the first week and weekly thereafter. Clinical evaluation consisted of an examination of femoral artery pulses, gait assessment and verification as to whether there was any pulsatile tumor, bruising, hemorrhage or surgical wound infection. One hundred and eighty days after the angioplasties, percutaneous Doppler velocimetry of the femoral arteries was performed under general anesthesia. Next, the dogs underwent dissection of the femoral arteries, measurement of the arterial diameter and perioperative Doppler velocimetry proximally and distally to the artery angioplasty. Laparotomy was then performed to expose the abdominal aorta for angiographic access. The femoral artery segments with patches were harvested for histopathologic analysis, and the animals were sacrificed under a toxic dosage of anesthetic. RESULTS: At 180 days, no cases of surgical wound infection, aneurysm, rupture, pseudoaneurysm or thrombosis were observed in either group. A chronic inflammatory reaction with lymphocytes and neutrophils was seen in both groups on the outer surface of patches. Fibrosis was seen on the inner and outer surfaces of the patches. Invasion by fibroblasts of all e-PTFE patches occurred in the control group. CONCLUSIONS: Based on the results obtained with the experimental model employed, for a 180-day period, it may be concluded that the sugarcane biopolymer membrane is an adequate arterial substitute when used as a patch in femoral artery angioplasty in dogs.

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