Implantation of amniotic membrane as a vascular substitute in the external jugular vein of juvenile sheep Habibollah Peirovi, MD, Navid Rezvani, MD,

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Implantation of amniotic membrane as a vascular substitute in the external jugular vein of juvenile sheep Habibollah Peirovi, MD, Navid Rezvani, MD, Mostafa Hajinasrollah, DVM, Seied Sajjad Mohammadi, MD, Hassan Niknejad, PharmD, PhD Journal of Vascular Surgery Volume 56, Issue 4, Pages 1098-1104 (October 2012) DOI: 10.1016/j.jvs.2012.02.036 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 A, The amniotic membrane-constructed conduit grafts were interposed to the external jugular vein by end-to-end anastomosis in a sheep model. The black arrow and arrowhead indicate cephalad and caudal anastomoses, respectively. B, The vascular graft is shown at 48 weeks after implantation. The white arrows designate the external jugular vein and the white arrowhead designates the implanted amniotic membrane-constructed conduit. Journal of Vascular Surgery 2012 56, 1098-1104DOI: (10.1016/j.jvs.2012.02.036) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Ultrasound imaging of the grafts at (A) 5 and (B) 48 weeks postoperatively indicated that the grafts were patent. Journal of Vascular Surgery 2012 56, 1098-1104DOI: (10.1016/j.jvs.2012.02.036) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Histologic and immunohistochemical staining of the luminal surface of (A) native vein 1 cm above anastomosis and the (B) amniotic membrane-constructed conduit (AMCC) is shown at 5 weeks postoperatively. Hematoxylin and eosin staining shows a monolayer of endothelial cells on the luminal surface of AMCC. C, A longitudinal section of anastomotic site after 48 weeks stained with hematoxylin and eosin showed that the graft integrated well with the native vein. The black arrow points to the anastomotic site, and the triangle and star indicate native vein and the graft, respectively. D, Immunostaining of sections from samples using antibodies against von Willebrand factor confirmed endothelial cells characteristic of luminal surface of AMCC. The inset shows 4',6-diamidino-2-phenylindole nuclear staining of the same field. Scale bar: 50 μm. Journal of Vascular Surgery 2012 56, 1098-1104DOI: (10.1016/j.jvs.2012.02.036) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 A, Scanning electron photomicrographs show that the amniotic epithelial cells of the fresh amniotic membrane are irregular polygonal or round in shape. B, The luminal surface of the amniotic membrane-constructed conduit contains cells with endothelial cells morphology that are confluent and distributed uniformly, without bare areas, in the luminal surface of grafts at 48 weeks postgrafting. Journal of Vascular Surgery 2012 56, 1098-1104DOI: (10.1016/j.jvs.2012.02.036) Copyright © 2012 Society for Vascular Surgery Terms and Conditions