IP08 - A Novel Antimicrobial Vascular Graft Demonstrates Effective Bacterial Control in a Porcine Carotid Transposition Infection Model

Objectives: Vascular graft infection is associated with high rates of limb loss and mortality, and its management is challenged by diagnostic limitations, antimicrobial resistance, and restricted evidence regarding available materials. This study evaluated in vivo bacterial control of a novel antimicrobial vascular graft intended for prevention and treatment of vascular graft infections.

Methods: Experimental, analytic, phase-0 parallel study with three arms. Fourteen 6–7-month-old pigs (40–55 kg) were used; five were allocated to model standardization and nine to intervention, randomized into: (1) control, (2) infection with antibiotic prophylaxis, and (3) infection without prophylaxis. All animals underwent carotid transposition with implantation of the study graft. Infection groups received inoculation with methicillin-resistant Staphylococcus aureus and ESBL-producing Escherichia coli. Weekly follow-up included duplex ultrasound assessment and complete blood count. All animals received aspirin plus rivaroxaban for antithrombotic prophylaxis. At 30 days, grafts were explanted and assessed by gross inspection, hematoxylin-eosin staining, and microbiologic cultures on blood agar and MacConkey agar.

Results: Nine intervention animals were analyzed, achieving 100% technical success. In inoculated animals, inflammatory markers increased with leukocytosis but without neutrophil left shift, suggesting adequate bacterial control. C-reactive protein was negative in most cases during follow-up. No relevant hematologic abnormalities were observed, including anemia, thrombocytosis, or thrombocytopenia. At explant, there was no gross evidence of bacterial presence, and no pathogen growth was observed in cultures in any study group.

Conclusions: In this porcine carotid transposition infection model, the novel antimicrobial vascular graft demonstrated effective bacterial control, supported by negative cultures and absence of gross bacterial findings at explant. Hematologic stability and largely negative C-reactive protein further support its potential as a promising option for prevention and treatment of vascular graft infections.