Human Umbilical Veins and Autogenous Veins as Canine Arterial Bypass Grafts

Abstract

Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observation whereas thrombosis occurred in seven of 15 umbilical vein grafts. This patency rate of 53% was significantly lower than that observed for autogenous jugular veins (p less than 0.01). Neointimal Fibrous Hyperplasia (NFH) a the proximal anastomosis was responsible for six of the seven umbilical vein graft occlusions. Of the eight patent umbilical veins, five had varying degrees of proximal anastomotic stenosis secondary to NFH. Histological examination of each graft revealed significant fibroblastic proliferation and collagen deposition within the lumen of stenosed and thrombosed grafts. Although human umbilical veins have distinct advantages over other prosthetics, such as availability and flexibility, the incidence of experimental neointimal fibrous hyperplasia causing anastomotic stenosis and thrombosis is prohibitively high.

Future Perspectives in Small-Diameter Vascular Graft Engineering

“…HUV has been applied as a vascular bypass graft since 1974, followed by commercialization, which was known as Biograft ® [ 200 , 201 ]. Several years later, the outcome of the use of Biograft ® was evaluated.…”

“…HUV is more difficult to be applied technically than SV or synthetic conduits. Moreover, hUV may lack elasticity, making it more fragile [ 200 , 201 , 202 , 204 , 205 ]. In addition, the crosslinking reagents used for its stabilization like glutaraldehyde could induce severe cytotoxicity.…”

Modern Approaches in Cardiovascular Disease Therapeutics: From Molecular Genetics to Tissue Engineering

“…The informed consent should fulfill the requirements of the National regarding cord tissue donation and also should be in accordance with the Helsinki declaration. HUV has been applied as a vascular bypass graft since 1974, followed by commercialization, was known as Biograft [200,201]. Several years later, the outcome of the use of Biograft was Specifically, a comprehensive evaluation of the use of hUV as a femoropopliteal bypass graft, a study involved 133 operations and a 5-year follow up, was performed [202].…”

“…HUV is more difficult to be applied technically than SV or synthetic conduits. Moreover, hUV may lack elasticity, making it more fragile [200][201][202]204,205]. In addition, the crosslinking reagents used for its stabilization like glutaraldehyde could induce severe cytotoxicity.…”

Infrainguinal Arterial Reconstruction

“…Also, in the 1970s a series of papers appeared with DeWeese as senior author describing the use of a canine model to compare the function of various prostheses and biological grafts with that of autogenous venous bypasses in the lower limbs. These studies had great impact in pointing out the superior patency of venous bypass grafts placed in arteries in the lower extremities in comparison with all alternatives [16][17][18].…”