Radiology, Vol 204, 757-763, Copyright © 1997 by Radiological Society of North America

ARTICLES

Perigraft inflammation due to Dacron-covered stent-grafts in sheep iliac arteries: correlation of MR imaging and histopathologic findings

K Schurmann, D Vorwerk, A Bucker, J Neuerburg, B Klosterhalfen, G Muller, R Uppenkamp and RW Gunther
Department of Diagnostic Radiology, University of Technology, Aachen, Germany.

PURPOSE: To evaluate with magnetic resonance (MR) imaging the inflammatory perigraft response after implantation of Dacron-covered and noncovered arterial endovascular prostheses in sheep. MATERIALS AND METHODS: Four prosthesis types--two Dacron-covered nitinol stent-grafts (plain and heparin-coated) and two noncovered nitinol stents (Memotherm and Cragg)--were each inserted into the external iliac arteries of eight sheep. MR imaging before and after gadolinium enhancement was performed 5-8 days and 1 month after implantation (before the animals were killed). Macroscopic and microscopic examinations of the vessels were performed, and findings were correlated with those on MR images. RESULTS: Severe inflammatory perigraft responses to the heparin-coated Dacron-covered stent-grafts were found; MR images demonstrated contrast enhancement and edema. Macroscopic examination showed marked vascular wall thickening and adhesions around the Dacron fabric; microscopic examination showed a pronounced inflammatory foreign-body response. There was a moderate inflammatory response to the plain Dacron-covered stent-grafts and almost no response to noncovered stents. CONCLUSION: In sheep, MR imaging findings of perigraft soft-tissue edema and contrast enhancement correlated well with histopathologic findings of severe perigraft inflammation due to heparin-coated Dacron-covered stent-grafts.

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