Biomedical subjects

R Guidoin

Publications and source records attributed to R Guidoin.

At least 109 records · Page 6Linked to original sources

PubMed1989

Nondestructive investigations on ninety-seven surgically excised mammary prostheses.

The information contained in the medical files of 68 patients having undergone surgical excision of a total of 97 internal mammary prostheses allowed us to define a typical patient profile at time of first implantation. Age: 33 years 11 months, height: 1.59 m, weight: 51.5 kg, two children. Twenty-one percent of these patients had the operation done subsequent to a mastectomy, while 79% requested it for cosmetic reasons. The duration of implantation was less than 55 months for 76% of the prostheses received after excision. The most frequent evolutive complications were the formation of a fibrous capsule followed by silicone bleeding, as well as mineralization. Macroscopic examination of the 97 explanted prostheses provided information on their integrity (38.1% of prostheses ruptured), gel differentiation (24.7%), sticky surfaces (26.8%), surface deposits (33%), memory folds (54.6%), and Dacron fixation patches (20.6%). According to the medical files, a fibrous capsule was found in association with 69.8% of the breast implants. We received only 46 capsules. The average thickness was 1.4 mm. Mineralizations were present on 15 capsules (32.6%). Two zinc phosphates were identified, for the first time, in human body: parascholzite and hopeïte. Statistical examination showed that Heyer-Schulte prostheses stayed in place for a longer time. Integrity and gel differentiation depended on the duration of the implantation. Presence of mineralization was model-related (Dow Corning prostheses were associated with deposits) and depended on the presence of fixation patches.

Adult↗

PubMed1989

An histo-morphological evaluation of ninety surgically excised human umbilical vein grafts.

Morphological, histological, and scanning electron microscopy examinations were performed on 90 surgically excised human umbilical vein grafts. Most of the explanted grafts were removed because of thrombosis or infection and were removed typically from a patient in the mid 60s and after an average duration of implantation of 11 months. Multiple structural defects were found including deep folds, breaks on the luminal surface, and delamination. These areas as well as anastomotic sites represented potential areas for thrombotic accumulation. A higher incidence of infection was observed in grafts composed of 2 or 3 segments. Bacteria were often found in folds and could be seen invading the wall of the prosthesis. In addition, bacteremic colonization was often seen in noninfected grafts. The late aneurysmal formations were also of particular concern. The biodegradation of the wall and the disruption of the polyester mesh were the probable causes. The second generation Dardik Biograft aimed at reducing these formations. The success of this new processing remains to be evaluated.

Adult↗

PubMed1989

In vivo biostability of four types of arterial grafts with impervious walls; their haemodynamic and pathological characteristics.

We describe the haemodynamic and pathological characteristics of four types of four impervious arterial prostheses, two alloplastic (Mitrathane and Gore-Tex), and two chemically processed bovine heterografts (Solcograft and Solco P). They were implanted in the thoracic aortae of dogs for durations of 24 hours, 48 hours, one week, two weeks, one month, three months and six months. Haemodynamic analyses showed no relation between the shear rate index, I.gamma, and compliance, CD. The observed shear rates are 6.5 times lower than those likely to damage the endothelial cell layer. Macroscopic and microscopic observations of explanted grafts showed the presence of obstructive thrombi at the anastomoses of Mitrathane grafts as early as one week. Gore-Tex grafts develop in the area of anastomoses parietal-thrombi which reorganize and become covered with pseudo-endothelial cells. The bovine heterografts show a similar behaviour. However, whereas Solcograft has an irregular thin wall, Solco P had improved characteristics except in the graft implanted for three months which demonstrated, some manufacturing weaknesses. Both types showed the development of anastomotic pannus covered with endothelial-like cells. All grafts, whether alloplastic or chemically processed, suffered from an absence of healing of the middle part of the prosthesis. The cause of this problem will be found in the analysis of the biochemical and enzymatic reactations between the material used and its physiological surrounding.

Anastomosis, Surgical↗

PubMed1989

Cellular reactions to polyester arterial prostheses impregnated with cross-linked albumin: in vivo studies in mice.

This study was designed to assess the possible immunological responses in mice against polyester prostheses coated with albumin and previously stabilized either with cross-linked glutaraldehyde (GA), at different concentrations, or with carbodiimide (CDI). Prosthetic discs were first implanted in the peritoneal cavities of mice, and T cells and T cell subsets (helper, suppressor, la-bearing T lymphocytes) were then quantified before implantation and at 1, 2, 3 and 4 weeks post-implantation. The percentages of T cells, subsets, and the helper/suppressor cell ratio, as well as the percentage of T cells with la receptors, were similar to the control in all experimental groups. No significant difference and no correlation were observed between the groups wherever tested. Virgin and albumin-coated grafts did not induce any quantitative changes in T cell subpopulations in mice.

Albumins↗

PubMed1989

Collagen coatings as biological sealants for textile arterial prostheses.

Two collagen-coated grafts were studied: Hemashield (bovine collagen cross-linked with formaldehyde vapours and softened by exposure to glycerol) and Tascon (collagen fibres cross-linked with glutaraldehyde solution). The weight of the coating was 310 +/- 5 mg/g for Hemashield and 45 +/- 2.5 mg/g for Tascon. However, notwithstanding these differences, both coatings were efficient in making the walls of the grafts impervious to blood. The water permeabilities for the Hemashield and the Tascon were 8.7 and 5.9 ml.min-1.cm-2 at 120 mmHg respectively. The Hemashield collagen coating was rapidly eroded in vitro (4 h) after exposure to buffer, trypsin or pancreatin solutions, whereas the Tascon collagen coating remained well preserved after 7 d incubation. Both coatings were safe and did not interfere with the physical properties of the graft which was used as a skeleton. The healing properties of the Hemashield were similar to that observed with preclotted polyester prostheses, except in the early hours following graft implantation. On the other hand, the absence of erosion in the coating of the Tascon seemed to contribute to early antithrombogenicity. It also induced marked inflammatory reactions in the surrounding tissues and thus the healing appeared to be delayed.

Animals↗

PubMed1989

Hydrophilic polyurethane versus autologous femoral vein as substitutes in the femoral arteries of dogs: quantification of platelets and fibrin deposits.

Hydrophilic, microporous polyurethane vascular prostheses displayed good mechanical characteristics and the behaviour in vitro was excellent. The in-vivo results were, however, disappointing. To obtain a better understanding of the phenomena involved in the acute and early thrombosis, we implanted the polyurethane graft in the canine left femoral artery and an autologous femoral vein in the right for 4 and 24 h. At 4 h, one polyurethane graft was totally occluded and the other two were close to complete occlusion; at 24 h, none was patent. On the other hand, all autologous veins were patent. The thrombotic matrix incorporating both platelets and fibrinogen, quantified by labelling, was anchored along the anastomotic lines. This study confirms that polyurethane occlusion is initiated by hyperplastic reaction, but does not explain why.

Animals↗

PubMed1989

Hydrophobic and fibrillar microporous polyetherurethane urea prosthesis: an ESCA study on the internal and external surfaces of explanted grafts.

The ESCA study gives a good qualitative and quantitative elemental analysis of internal and external surfaces of foreign materials. Microporous hydrophobic Mitrathane (a polyetherurethane urea) grafts were implanted as blood conduits in dogs for up to 6 months. Surface analysis of explanted grafts demonstrated the presence of different contaminants: sodium, chlorine, silicon, in patent grafts, i.e. those implanted for 1 month and less. The sulphur probably comes from the presence of proteins on the surface of the polymer and the high level of nitrogen is also protein-related. At 6 month implantation, the grafts were occluded and a decrease of proteins on the surface was observed. The values of N/C and O/C ratios are also reported. For the virgin material, these ratios correspond to the quantity of hard and soft segments; but, for the explanted grafts, these parameters are also influenced by the presence of proteins due to the Versaclean washing which did not wash away all the proteins on the surface of the polymer. The SEM photographs showed a certain degradation of polyurethane after 6 month of implantation. However, by ESCA study, it is difficult to compare the surface of virgin and explanted grafts because it is masked by the presence of proteins.

Animals↗

PubMed1989

In vivo evaluation of hydrophobic and fibrillar microporous polyetherurethane urea graft.

Mitrathane hydrophobic and fibrillar microporous prosthesis was implanted as infrarenal arterial substitute in dogs; it was evaluated in terms of patency rates, healing characteristics and biostability. Segments of grafts were implanted in duplicate for a period of implantation of 24 h, 1 wk, 1 month and 6 month. Two control grafts from the Ontario Research Foundation were implanted: one for 1 month, the other for six month. All except the two Mitrathane grafts implanted for 6 month were patent at death. The Mitrathane grafts showed kinking at one and 6 month post-implantation. The ORF graft implanted for 1 month was found crinkled in its mid-section and the external capsule was ruptured in the graft implanted for 6 month, without crinkling. Histological studies showed fibrin deposits on the flow surface and infiltration of blood elements into the wall of the Mitrathane grafts implanted for 24 h and 1 wk. A thin internal capsule was present on the graft flow surface of both types of graft tested 1 month post-implantation; scanning electron microscopy revealed the presence of endothelial-like cells on the luminal surface, particularly in the vicinity of the anastomoses. At 6 month, the Mitrathane grafts were occluded by a thick thrombus originating from the anastomoses, while the ORF graft showed infiltration of collagen through the polyurethane fibrillar structure of the wall with an endothelial-like lining covering the flow surface in the vicinity of both anastomoses.

Animals↗

PubMed1989

In vivo evaluation of four chemically processed biological grafts implanted as infrarenal arterial substitutes in dogs.

Four chemically processed grafts implanted as arterial substitutes in dogs were evaluated as blood conduits in terms of patency rates, healing characteristics and biostability. Omniflow, Biopolymeric, Dardik-Biograft of the second generation and BIMA grafts were implanted as infrarenal aortic substitutes for 4, 24 and 48 h (short-term), 1, 2 and 4 wk (medium-term), 3 and 6 month (long-term), each type of graft being implanted for a complete series. The explanted grafts were evaluated macroscopically and processed for light and scanning electron microscopy. One Omniflow graft was occluded at 6 months and two Dardik-Biografts were thrombosed, one at 24 h and one at 1 month. All explanted grafts in the Biopolymeric series and in the BIMA were patent at the animals' death. Histological studies revealed frequent subintimal fibrosis in the Biopolymeric and Omniflow grafts. A peripheral inflammatory reaction was present in most grafts explanted. Scanning electron microscopy showed an aggravation of flow surface irregularities, after implantation of Omniflow, Biopolymeric and Dardik-Biograft, compared to virgin prostheses. These grafts presented an internal capsulae on the graft flow surface along the anastomoses. The capsulae slightly extended towards the centre of the graft after long-term implantation, (6 month) and corresponded to the pannus. Endothelial-like cells covered this pannus. The BIMA graft performed the most satisfactorily and retained its blood compatibility best, that is, the luminal surface was smooth with only minor thrombotic deposits and a thin pannus along the anastomotic lines.

Animals↗

PubMed1989

An arterial prosthesis from Argentina: the Barone Microvelour arterial graft.

The manufacture of a polyester vascular prosthesis in the southern hemisphere is a new development in the global dissemination of this maturing technology. Hence the recent introduction of the Barone Microvelour arterial graft from Argentina has highlighted the need for a comparative in vitro and in vivo study to compare its structure and performance with that of existing commercial products. Following a series of laboratory tests and implantations as a thoracoabdominal bypass in dogs, the Barone Microvelour has been identified as a strong graft constructed after the style of early weft-knitted designs. It provides an equivalent sequence and rate of healing to that of other polyester knitted grafts.

Animals↗

PubMed1989

First observation of hopeïte and parascholzite in fibrous capsules surrounding silicone breast implants.

We observed mineralization in 32.6% of the capsular tissue of 97 mammary prostheses recovered after surgical excision. Three distinct mineralogical phases were identified. The first was composed of common hydrated carbonate hydroxylapatite, a well-known physiological and pathological mineral. Hopeïte and parascholzite constituted the second and third phases. They are zinc and calcium hydrate phosphates that have not been observed previously in human tissues. Statistical analysis of the data showed relationships between the presence of mineralizations and the manufacturers on the one hand, and the presence of Dacron fixation patches at the surface of the prostheses on the other.

Breast↗

PubMed1989

Comparison of processed bovine internal mammary arteries and autologous veins as arterial femoral substitutes in dogs: blood compatibility and pathological characteristics.

This study was undertaken to compare the chemically processed internal mammary artery (BIMA) and the autologous femoral vein as arterial grafts. The BIMA prosthesis was implanted as a left femoral artery bypass and the femoral vein as a right femoral artery bypass graft in 27 dogs. In groups of three dogs the grafts were implanted for predetermined durations: 4, 24 and 48 hours (short term), 1, 2 and 4 weeks (medium term) and 3, 6 and 9 months (long term). All autologous veins were patent when the dogs were killed. The patency rates of the BIMA grafts were 100% in the short-term group, 67% in the medium-term group and 29% in the long-term group. The deposition of labelled fibrinogen and platelets on flow surfaces, the structural preservation of the wall of the BIMA prosthesis and accumulation of thrombi during the period of implantation were studied.

Animals↗

PubMed1989

Expanded polytetrafluoroethylene prostheses as secondary blood access sites for hemodialysis: pathological findings in 29 excised grafts.

The popularity of expanded polytetrafluoroethylene (PTFE) arteriovenous fistulas for hemodialysis access is increasing. The low infection rate, low thrombogenicity and low body reactivity make it an important blood access for patients on routine hemodialysis. The authors examined 29 PTFE graft fistulas surgically excised from patients on hemodialysis for one or more of the following complications: infection 7, 2 with associated hemorrhage; thrombosis 9; aneurysm 11, 3 with associated thrombosis; stenosis 5, 3 with associated thrombosis; hemorrhage 4 and arterial steal 2. The explanted prostheses were reinforced Gore-tex in 20, Gore-tex thin wall in 1, Impra I in 4, Impra II in 3 and Vitagraft in 1. It was also noted that the implants failed in the short term mainly because of infection, in the medium term mainly because of thrombosis and stenosis, and in the long term usually because of aneurysm.

Adult↗

PubMed1989

Biologic and structural evaluation of 80 surgically excised human umbilical vein grafts.

Human umbilical vein is a valuable alternative to autogenous saphenous vein in lower-limb revascularization. However, the long-term patency is not as good. To understand better the reasons for this, the authors studied the biologic and structural changes occurring in 80 segments of human umbilical vein (HUV) grafts excised from 70 patients. Morphologic, histologic and scanning electron microscopy examinations were performed on each specimen. It was noted that increasing duration of implantation was associated with greater encapsulation and less surrounding inflammatory reaction. Twenty-six percent of clinically noninfected grafts were found to harbour bacteria. Bacteremic colonization was often in the folds of the luminal surface. As a result of these findings, the authors emphasize the need for complete excision of clinically infected grafts. Anastomoses between HUV segments are discouraged because they are associated with a high frequency of infection and a corresponding decrease in duration of implantation. Delamination of the wall was common, and such sites may represent areas at risk for further degradation. Continued surveillance of the biologic and structural changes occurring in excised grafts remains an important method in increasing our understanding of the evolutive complications of HUV grafts.

Adult↗

PubMed1988

Hydrophilic microporous polyurethane versus expanded PTFE grafts as substitutes in the carotid arteries of dogs. A limited study.

A novel, microporous, hydrophilic polyether urethane-urea (PEUU) vascular graft was compared with expanded PTFE in the canine carotid artery. At implantation times ranging from 4 h to 6 months, all the PEUU grafts were found to be occluded while of the PTFE grafts, only those implanted for 1 week and 6 months were blocked. Histopathological analysis of the explanted grafts and their capsules revealed an ongoing inflammatory reaction at the anastomotic sites of the PEUU grafts.

Animals↗

PubMed1988

The hydrolytic stability of Mitrathane (a polyurethane urea)--an x-ray photoelectron spectroscopy study.

The hydrolytic stability of microporous Mitrathane polyetherurethane urea vascular prostheses has been evaluated at pH 7 and pH 9, at 37 degrees, 60 degrees, and 80 degrees C for time periods of up to 968 days. Mechanical strength was evaluated using a hydrodynamic burst test and surface chemical changes by x-ray photoelectron spectroscopy. The samples held at 80 degrees C showed the greatest mechanical strength loss which corresponded to the hydrolysis of the urethane groups. It was concluded that the gross in vivo surface degradation of Mitrathane prostheses, observed after six months, could not have been caused by simple chemical hydrolysis alone, as the polymer was found to be stable at 37 degrees C for at least 11 months.

Animals↗

PubMed1988

Experimental colonization of a polyester vascular graft with Staphylococcus aureus: a quantitative and morphologic study.

Colonization of a polyester (Dacron) vascular graft by Staphylococcus aureus 209P-R was studied. Twenty-five dogs had thoracoabdominal aortic bypass. After intervals of 2 hours (three dogs), 8 days (five dogs), 1 month (six dogs), 2 months (six dogs), or 6 months (five dogs), a bacteremic challenge was produced by intravenous injection of 6 x 10(8) colony-forming units of S. aureus. Two hours later grafts were removed and cut into 10 fragments, each submitted to bacterial counts and scanning electron microscopic studies. Results of bacterial counts were expressed in colony-forming units (CFU) per square centimeter of graft segment (median [lower to upper quartiles]). Normal canine aortas (n = 2) used as controls trapped no bacteria. Colonization of Dacron grafts varied according to the duration of graft function (p less than 0.01): after 2 hours, 4416.5 CFU (1158 to 9073 CFU); after 8 days, 1515 CFU (963 to 2893 CFU); after 1 month, 199 CFU (86 to 538 CFU); after 2 months, 615 CFU (243 to 1407 CFU); and after 6 months, 1 CFU (1 to 5 CFU). Heavily colonized fragments were observed for duration of graft function of 2 months or less, whereas at 6 months all the fragments trapped fewer than 50 CFU/cm2 of graft segment. Scanning electron microscopy showed that colonization was closely associated with healing. Staphylococcal entrapment was related to the amount of fibrin deposits, which were especially abundant where the thrombotic matrix was unorganized and on bare polyester filaments. Graft colonization is especially to be feared in the first weeks after graft implantation, an observation which may help to define guidelines for preventing hematogenous vascular graft infection.

Animals↗

PubMed1988

Polyester arterial grafts impregnated with cross-linked albumin: the rate of degradation of the coating in vivo.

One of the techniques used to avoid preclotting a porous textile arterial prosthesis is to coat the graft with a layer of a bioerodible polymer. The efficacy of this treatment is dependent in part on the rate at which the polymer degrades after implantation. The focus of this study was therefore to investigate the rate of in vivo degradation of albumin-coated polyester (Dacron)-knitted vascular prostheses. Two types of cross-linked albumin were included: one using glutaraldehyde, the other using carbodiimide as the cross-linking agent. Radioactively labeled albumin-coated prostheses were implanted in the thoracic aorta and peritoneal cavity of dogs, and their rates of biodegradation in vivo were monitored over a 4-week period. The rate of biodegradation was found to depend upon the site of implantation. It occurred more rapidly in the peritoneal cavity where less than 20% of the albumin coating remained after 4 weeks in vivo in comparison to the approximately 30% in the thoracic aorta. The nature and intensity of the cellular response appeared to be related to the cytotoxic potential of the cross-linking agent. Glutaraldehyde induced an inflammatory response and a delay in healing, whereas carbodiimide caused only a mild tissue reaction.

Animals↗