Chemically processed bovine heterografts of the second generation as arterial substitutes: a comparative evaluation of three commercial prostheses.

The use of chemically processed bovine heterografts is primarily confined to the construction of arterio-venous blood accesses in those patients requiring hemodialysis, plasmapheresis or chemotherapy. The grafts of the first generation i.e. Artegraft and Solcograft are now being supplanted by those of the second generation i.e. Reinforced Artegraft, Solco P and NCGT. We have investigated these three types of arterial prostheses as a biomaterial in terms of sterility, inflammatory response and cytocompatibility and as a blood conduit in dogs in terms of patency and healing. For each type of graft, two implantations were carried out for durations of 4 hours, 24 hours, 48 hours, one week, two weeks, one month, three months, and six months. Therefore a total of 48 grafts were implanted. All grafts but five were patent at sacrifice: thromboses were observed in two Reinforced Artegraft (after two weeks and after one month) and in three NCGT (after 24 hours, after 48 hours, and after one month). Therefore the following patencies were observed: Reinforced Artegraft 14/16, Solco P 16/16 and NCGT 13/16. In all the patent grafts, the healing was reduced to the formation of a pannus along both anastomoses; thrombotic accumulations were observed on the surface defects of the grafts, particularly the NCGT graft. The Reinforced Artegraft presents only minor advantages over the previous Artegraft; the Solco P, somewhat more acceptable is no longer commercially available since the manufacturer withdrew it after early clinical failures. The improvements noted in the bovine heterografts of the second generation appear to be marginal as compared to those of the first generation.