Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

• Autor(es):

  Pinto, Cristina Ribeiro Riguetti (Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Cirurgia Geral);

  Chouin, Celso Luiz Muhlethaler (Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Cirurgia Geral);

  Espinosa Lopez, Gaudencio (Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Cirurgia Geral).

• Fonte:

  Jornal Vascular Brasileiro; volume 5, número 2, páginas 81-88. Junho 2006.

• Assuntos:

  Stent-graft;

  bioprosthesis;

  jugular veins;

  cattle;

  inferior vena cava;

  histocompatibility.

• Resumo:

  OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for aortic stent-graft deployment (Florida, USA). Ten handmade stent-grafts were implanted in 10 swine inferior venae cavae. All animals were submitted to perioperative venography. At necropsy, 2 months later, the stent-grafts were removed en bloc and histopathologic analysis was undertaken, in order to analyze its patency, adherence to neighboring tissues and incorporation to the venous wall, as well as tissue response. RESULTS: All stent-grafts were patent and adherent to venous wall, but six presented with gross trabeculation and four had some degree of perivascular fibrosis at macroscopy. Three animals developed lymphocele, one in the retroperitoneal space and the others in the abdominal wall. At histopathology, we observed chronic inflammatory reaction with foreign body granulomatous response in all cases, with prevalence of the tunica media (80%). CONCLUSION: The model presented low thrombogenicity, which corroborates the efficacy of the chosen means of preservation and material. However, there was low compatibility, probably due to the immunological obstacle of xenografts and exaggerated tissue response of the venous territory.

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