Silver Graft is een kettinggeweven dubbel-velour vaatprothese van polyester (polyethyleentereftalaat/pegoteraat), die is geïmpregneerd met resorbeerbare gemodificeerde gelatine (Polygeline). Om microbiële adhesie te voorkomen is het oppervlak van de textielprothese gecoat met een laag zilver. De gelatine-impregnatie vermindert de initiële porositeit van de prothese op het moment van implantatie. Silver Graft wordt zowel in rechte vorm als in bifurcatie geleverd.
Werking
De functionele eigenschappen van Silver Graft zijn gebaseerd op het principe dat een zeer poreuze textielconstructie tijdelijk wordt afgedicht door een biologisch afbreekbare massa, die geen onafhankelijke farmacologische eigenschappen bezit. Deze gemodificeerde gelatine vermindert de initiële porositeit van de textielprothese op het moment van implantatie tot ongeveer 0 ml/min/cm2. Van buitenaf wordt de impregnering van de prothese enzymatisch afgebroken en geabsorbeerd binnen 4-6 weken na implantatie, zoals blijkt uit een publicatie van Ueberueck et al. in 2005. Gedurende deze periode neemt endogeen weefsel de prothese op in het omringende weefsel en neemt het de afdichtende functie over.
De zilverionen op het oppervlak van de vaatprothese hebben een antimicrobiële (bacteriostatische en bacteriedodende) werking. Daarom heeft Silver Graft een aanzienlijke vermindering van de microbiële hechting aan het oppervlak van de textielprothese, hetgeen door preklinische in vivo en in vitro proeven is bevestigd. Hierbij zorgt een langzame afgifte van de zilverionen voor langdurige antimicrobiële eigenschappen.
Bij Silver Graft Helix wordt met een externe polypropyleendraad om de buitenkant van de prothesewand gewikkeld om de prothese te beschermen tegen mechanische druk van buitenaf en de knikstabiliteit te vergroten.
Beoogd gebruik
MRI-veiligheid en compatibiliteit
Magnetic resonance Imaging (MRI) kan veilig worden uitgevoerd bij patiënten met geïmplanteerde Silver Graft vaatprothesen onder de volgende omstandigheden:
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