We compared graft outcome between two types of a novel
composite three-layer carp-collagen-coated vascular graft in
low-flow conditions in a sheep model. Collagen in group A
underwent more cycles of purification than in group B in order to
increase the ratio between collagen and residual fat. The grafts
were implanted end-to-side in both carotid arteries in sheep
(14 grafts in 7 sheep in group A, 18 grafts in 9 sheep in group B)
and artificially stenosed on the right side. The flow in the grafts
in group A decreased from 297±118 ml/min to 158±159 ml/min
(p=0.041) after placement of the artificial stenosis in group A,
and from 330±164ml/min to 97±29 ml/min (p=0.0052) in
group B (p=0.27 between the groups). From the five surviving
animals in group A, both grafts occluded in one animal 3 and 14
days after implantation. In group B, from the six surviving
animals, only one graft on the left side remained patent
(p=0.0017). Histology showed degradation of the intimal layer in
the center with endothelization from the periphery in group A
and formation of thick fibrous intimal layer in group B. We
conclude that the ratio between collagen and lipid content in the
novel three-layer graft plays a critical role in its patency and
structural changes in vivo.