Rapid neointima formation with elastic laminae similar to the natural arterial wall on an adipose tissue fragmented vascular prosthesis.

A vascular prosthesis that can induce a neointima similar to a natural arterial wall is reported. The authors have developed a sealing method using autologous tissue fragments. The sealed graft showed many advantages, with characteristic neointima formation in an animal study. The grafts were implanted in the thoracic descending aortae of 40 dogs and were removed from 1 hour to 608 days after implantation. Another 40 dogs, used as controls, had a fabric graft implanted using the preclotting method. The luminal surface of the sealed graft was completely endothelialized and the original adipose tissue fragments were absorbed within 1 month. Smooth muscle cells infiltrated and proliferated at the same time as endothelialization took place. Most of the smooth muscle cells were arranged in parallel rows and oriented circumferentially within the graft. At 1 month, elastic fibers appeared around the smooth muscle cells near the anastomotic sites. In the long-term specimens, these elastic fibers constituted a fine lamina in the neointima. Intimal hyperplasia and degenerative changes in the neointima were not observed. These results indicated that the sealing method could induce a very stable neointima with a smooth muscle cell layer and elastic laminae similar to a natural arterial wall within a short period of time throughout the graft wall, with maintenance of the neointima for a long period of time after implantation.