Enhanced graft healing of high-porosity expanded polytetrafluoroethylene grafts by covalent bonding of fibronectin.

The effect of covalent bonding of fibronectin on the patency and graft healing of high-porosity expanded polytetrafluoroethylene (ePTFE) grafts was evaluated. Bilateral carotid grafting was performed in ten mongrel dogs using high-porosity (60 microm) ePTFE grafts, 4 cm in length and 4 mm in internal diameter, that either had been pretreated by the covalent bonding of fibronectin (fibronectin grafts) or were untreated (control grafts). The grafts were harvested 4 to 6 weeks after surgery and subjected to macroscopic and light-microscopic observations. There was no significant difference in patency between the fibronectin grafts and the control grafts with rates of 80% and 70%, respectively. The thrombus-free area score was significantly greater in the fibronectin grafts than in the control grafts, at 86.9% vs 34.0%. Furthermore, the pseudointima was better replaced by fibrous tissue in the fibronectin grafts than in the control grafts, being lined with a layer of endothelial-like cells. More transmural tissue ingrowth was evident in the fibronectin grafts than in the control grafts. The covalent bonding of fibronectin improves graft healing by stimulating transmural tissue ingrowth in high-porosity ePTFE grafts.