Objective: To investigate the impact of intravenous combination chemotherapy with 5-fluorouracil (5-FU) and cisplatin (DDP) on prosthetic vascular grafts in dogs.
Methods: The model of reconstruction of abdominal aorta using ePTFE prosthetic vascular graft was established in 12 dogs, which were equally randomized into chemotherapy group and control group. The chemotherapy group underwent intravenous combination chemotherapy with 5-FU (10 mg/kg) and DDP (1 mg/kg) once daily for 5 days during the 2nd week after operation, and the control group received transfusion with an equivalent volume of vehicle. Physiological parameters of the dogs during the period of intervention were recorded. Graft specimens from five levels were harvested at the 4th week after chemotherapy or vehicle transfusion (6th week after operation) to determine the intimal thickness, CD34 and proliferating cell nuclear antigen (PCNA) expression.
Results: One death (1/6) occurred in chemotherapy group and none (0/6) in control group. Two cases (2/5) in chemotherapy group developed a small amount of mural thrombus formation in prosthetic vascular graft, but that was not found (0/6) in control group. Between-group comparison results were as follows: No statistical difference was noted in intimal thickness of prosthetic vascular graft between the two groups (P＞0.05); the CD34+ cell ratio on the middle segment of prosthetic vascular graft of chemotherapy group was significantly lower than that of control group (P＜0.05), while the CD34+ cell ratio on other levels of prosthetic vascular graft showed no statistical difference between the two groups (P＞0.05); the PCNA expression of intimal area had no statistical difference between the two groups (P＞0.05). Within-group comparison results were as follow: The intimal thickness and CD34+ cell ratio on middle segment of prosthetic vascular graft were all lower than those on anastomotic stomas (P＜0.05 or P＜0.01); the PCNA expression levels of the proximal stomas were all higher than those of the distal stomas (both P＜0.05), and the PCNA expression levels in both sides of stomas were all higher than those of the middle segment of prosthetic vascular grafts (both P＜0.05).
Conclusions: Postoperative intravenous combination chemotherapy with 5-FU and DDP given during the 2nd week after prosthetic vessel replacement has transient retardant effect on the endothelial coverage of the middle segment of prosthetic vascular graft, resulting in the increased incidence of mural thrombus formation of prosthetic vascular graft. However, it has no significant influence on anastomotic healing, and does not increase the incidence of infection or rupture of the graft.