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Ghazanfari S, Alberti KA, Xu Q, Khademhosseini A. Evaluation of an elastic decellularized tendon-derived scaffold for the vascular tissue engineering application. J Biomed Mater Res A 2019; 107:1225-1234. [PMID: 30684384 DOI: 10.1002/jbm.a.36622] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/26/2018] [Accepted: 12/30/2018] [Indexed: 12/20/2022]
Abstract
Due to the limited success rate of currently available vascular replacements, tissue engineering has received tremendous attention in recent years. A main challenge in the field of regenerative medicine is creating a mechanically functional tissue with a well-organized extracellular matrix, particularly of collagen and elastin. In this study, the native collagen scaffold derived from decellularized tendon sections, as a scaffold having the potential to be used for vascular tissue engineering applications, was studied. We showed that the elasticity of the scaffolds was improved when crosslinked with the bovine elastin. The effect of different concentrations of elastin on mechanical properties of the collagen scaffolds was evaluated of which 15% elastin concentration was selected for further analysis based on the results. Addition of 15% elastin to collagen scaffolds significantly decreased Young's modulus and the tensile stress at the maximum load and increased the tensile strain at the maximum load of the constructs as compared to those of the collagen scaffolds or control samples. Moreover, tubular elastin modified collagen scaffolds showed significantly higher burst pressure compared to the control samples. Smooth muscle cells and endothelial cells cultured on the elastin modified collagen scaffolds showed high viability (>80%) after 1, 3, and 7 days. Furthermore, the cells showed a high tendency to align with the collagen fibers within the scaffold and produced their own extracellular matrix over time. In conclusion, the results show that the decellularized tendon sections have a great potential to be used as scaffolds for vascular tissue engineering applications. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1225-1234, 2019.
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Affiliation(s)
- Samaneh Ghazanfari
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard-Massachusetts Institute of Technology, Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts.,Aachen-Maastricht Institute for Biobased Materials, Faculty of Science and Engineering, Maastricht University, Geleen, The Netherlands
| | - Kyle A Alberti
- Department of Biomedical Engineering, Tufts University, Boston, Massachusetts
| | - Qiaobing Xu
- Department of Biomedical Engineering, Tufts University, Boston, Massachusetts
| | - Ali Khademhosseini
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard-Massachusetts Institute of Technology, Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts.,Department of Bioindustrial Technologies, College of Animal Bioscience and Technology, Konkuk University, Hwayang-dong, Gwangjin-gu, Seoul, Republic of Korea.,Department of Bioengineering, Department of Radiology, Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, California
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Pabittei DR, Heger M, Simonet M, van Tuijl S, van der Wal AC, Beek JF, Balm R, de Mol BA. Biodegradable polymer scaffold, semi-solid solder, and single-spot lasing for increasing solder-tissue bonding in suture-free laser-assisted vascular repair. J Tissue Eng Regen Med 2011; 6:803-12. [PMID: 22121070 DOI: 10.1002/term.486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 02/01/2011] [Accepted: 07/12/2011] [Indexed: 11/11/2022]
Abstract
We recently showed the fortifying effect of poly-caprolactone (PCL) scaffold in liquid solder-mediated laser-assisted vascular repair (ssLAVR) of porcine carotid arteries, yielding a mean ± SD leaking point pressure of 488 ± 111 mmHg. Despite supraphysiological pressures, the frequency of adhesive failures was indicative of weak bonding at the solder-tissue interface. As a result, this study aimed to improve adhesive bonding by using a semi-solid solder and single-spot vs. scanning irradiation. In the first experiment, in vitro ssLAVR (n=30) was performed on porcine abdominal aorta strips using a PCL scaffold with a liquid or semi-solid solder and a 670-nm diode laser for dual-pass scanning. In the second experiment, the scanning method was compared to single-spot lasing. The third experiment investigated the stability of the welds following hydration under quasi-physiological conditions. The welding strength was defined by acute breaking strength (BS). Solder-tissue bonding was examined by scanning electron microscopy and histological analysis was performed for thermal damage analysis. Altering solder viscosity from liquid to semi-solid solder increased the BS from 78 ± 22 N/cm(2) to 131 ± 38 N/cm(2) . Compared to scanning ssLAVR, single-spot lasing improved adhesive bonding to a BS of 257 ± 62 N/cm(2) and showed fewer structural defects at the solder-tissue interface but more pronounced thermal damage. The improvement in adhesive bonding was associated with constantly stronger welds during two weeks of hydration. Semi-solid solder and single-spot lasing increased welding strength by reducing solder leakage and improving adhesive bonding, respectively. The improvement in adhesive bonding was associated with enhanced weld stability during hydration.
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Affiliation(s)
- Dara R Pabittei
- Department of Cardio-thoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
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Bilici T, Mutlu S, Kalaycioglu H, Kurt A, Sennaroglu A, Gulsoy M. Development of a thulium (Tm:YAP) laser system for brain tissue ablation. Lasers Med Sci 2011; 26:699-706. [DOI: 10.1007/s10103-011-0915-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 03/17/2011] [Indexed: 11/29/2022]
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Sarkar S, Hillery C, Seifalian A, Hamilton G. Critical parameter of burst pressure measurement in development of bypass grafts is highly dependent on methodology used. J Vasc Surg 2006; 44:846-52. [PMID: 17012007 DOI: 10.1016/j.jvs.2006.07.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 07/06/2006] [Indexed: 12/31/2022]
Abstract
BACKGROUND Because of the low patency rate of currently available vascular bypass grafts, researchers are working towards the development of alternative bypass grafts, ranging from synthetic prostheses to wholly biologic living grafts. The philosophy of measurement required by regulatory agencies such as the United States Food and Drug Administration (FDA) as well as to gain the Conformité Européene (CE) mark is to test above and beyond the limits that would be expected physiologically. The critical parameter of burst pressure is needed for Conformité Européene (CE) mark or United States Food and Drug Administration (FDA) approval before clinical trials can proceed. An accurate measurement of burst pressure in potential porous vascular bypass grafts is, therefore, of utmost importance to ensure adequate strength on implantation in animals and subsequent clinical use. A wide range of methods to measure burst pressure have been used. We tested the burst pressure of a new polyurethane-based nanocomposite vascular prosthesis by using different methods to assess whether the method used affected the results. METHODS Water was infused at flow rates of 0.2, 50, and 100 mL/min through a syringe pump into latex sleeve-lined porous prostheses manufactured from a poly(carbonate-urea)urethane nanocomposite incorporating silsesquioxane. At the lowest infusion rate, the inflation was done with and without a nonporous inner lining sleeve. A pressure transducer was used to record the peak pressure achieved. RESULTS Using a nonporous sleeve resulted in a higher burst pressure (428 mm Hg vs 341 mm Hg) at a flow rate of 0.2 mL/min. A lower infusion rate (0.2 mL/min) produced a lower burst pressure than 50 mL/min (428 mm Hg vs 451 mm Hg). No significant difference was found in burst pressure using infusion rates of 50 mL/min and 100 mL/min. CONCLUSIONS The use of a nonporous sleeve removes the potential weakness presented by the pores themselves. A continuous high infusion rate consistently overestimates burst pressure. These methods may not reflect the physiologic state. Care needs to be taken in interpretation of methodology for burst pressure measurement, and the rate of infusion should be stated in any description of the method. CLINICAL RELEVANCE The poor patency of small-caliber vascular bypass prostheses has stimulated a large body of research into alternative graft materials. This includes synthetic and, more recently, tissue-engineered hybrid products. Acceptance for international standards requires demonstration of a rigorous mechanical testing regimen, including graft strength, which has on the whole involved burst strength measurement. However, the methods used to measure burst strength have varied with respect to apparatus used and rate of graft inflation. We show that these variables lead to markedly different results. In particular, fast infusion rates may overestimate the actual burst pressure, leading to a false sense of security.
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Affiliation(s)
- Sandip Sarkar
- Biomaterials & Tissue Engineering Centre (BTEC), Academic Division of Surgical and Interventional Sciences, Royal Free and University College Medical School, University College London, London, United Kingdom
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Khadem J, Martino M, Anatelli F, Dana MR, Hamblin MR. Healing of perforating rat corneal incisions closed with photodynamic laser-activated tissue glue. Lasers Surg Med 2005; 35:304-11. [PMID: 15493025 PMCID: PMC3071689 DOI: 10.1002/lsm.20099] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Laser-activated photodynamic biologic tissue glues may be useful for closing incisions in ophthalmology. We report on the use of two such preparations to close perforating corneal incisions in living rats. STUDY DESIGN/MATERIALS AND METHODS A previously described preparation containing a covalent albumin-chlorin e6 (ce6) conjugate (bovine serum albumin (BSA)-ce6), and a novel mixture of albumin and Janus Green (BSA/JG), both activated with a 665-nm diode laser were used to glue mouse skin ex vivo. The optimized glues were then used to seal incisions in rat corneas and results were compared to control incisions. Rats were sacrificed at day 1, 7, and 14 and eyes tested for leaking pressure and examined histopathologically. RESULTS One day after treatment eyes closed with BSA-ce6 had a leaking pressure (in mmHg) of 357 compared to 193 for control incisions (P<0.01); closure with BSA/JG gave a leaking pressure of 430 (P<0.05 compared to BSA-ce6, and P<0.001 compared to control). Histological examination showed eyes sealed with BSA/JG have less inflammation present than untreated eyes at 7 days. CONCLUSIONS These data demonstrate that photodynamic laser activated tissue glues can be used to effectively seal corneal incisions in living animals without thermal damage or undue inflammation.
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Affiliation(s)
- John Khadem
- The Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts
| | - Michael Martino
- The Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts
| | - Florencia Anatelli
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - M. Reza Dana
- The Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
- Correspondence to: Michael R. Hamblin, PhD, BAR314B, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114.
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Ott B, Constantinescu MA, Erni D, Banic A, Schaffner T, Frenz M. Intraluminal laser light source and external solder: In vivo evaluation of a new technique for microvascular anastomosis. Lasers Surg Med 2004; 35:312-6. [PMID: 15493022 DOI: 10.1002/lsm.20096] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Current laser-assisted end-to-end anastomoses are performed by irradiating the vessel wall from outside after additional fixation with three to six sutures. These sutures are needed to provide adequate approximation of the vessel stumps. We present a new laser soldering technique that is based on an intraluminal laser light source centered in a balloon catheter, and external application of a solder. This technique was applied in vivo in order to test its feasibility under clinical conditions. STUDY DESIGN/MATERIALS AND METHODS Seven white pigs were treated with a total of fourteen end-to-end laser-anastomoses of their saphenous arteries having outer diameters of 2 mm. The vessels were stented over an intraluminal balloon catheter, which was maximally dilated and which allowed for a precise approximation of the vascular stumps. An 808 nm diode laser was coupled into a specially designed optical fiber producing a 360 degrees radiation ring inside the balloon catheter. An indocyanine green (ICG) doped liquid albumin solder was applied on the external surface of the vascular stumps. Laser soldering was achieved by irradiating with a 808 nm laser diode for 75 seconds. Tightness of the anastomoses was evaluated by clamping the artery distal to the anastomosis for 1 hour, and patency was tested over an observation period of 3 hours, during which the animals were heparinized. Thereafter, the anastomoses were harvested for histomorphological examination. RESULTS All anastomoses remained patent over the entire observation period. Some leakage was observed in three anastomoses, which was explained by a deviation of the illumination fiber from the center of the balloon leading to an inhomogeneous irradiation of the vessel wall. Histology revealed perfect adaptation of the vascular stumps. A segment of denaturated vascular collagen was observed, that corresponded to the irradiated, solder-covered zone. CONCLUSION Patent, maximally dilated and well adapted microvascular anastomoses could be obtained without the need of stay sutures. A well centered laser light source is indispensable for avoiding inhomogenous welding, thus causing leakage.
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Affiliation(s)
- Beat Ott
- Institute of Applied Physics, University of Bern, Sidlerstrasse 5, 3012 Bern, Switzerland
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Wolf-de Jonge ICDYM, Beek JF, Balm R. 25 Years of Laser Assisted Vascular Anastomosis (LAVA): What Have We Learned? Eur J Vasc Endovasc Surg 2004; 27:466-76. [PMID: 15079768 DOI: 10.1016/j.ejvs.2004.02.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Laser assisted vascular anastomosis (LAVA) has been developed to a stage where clinical use is within reach. Advantages of LAVA are minimal vessel damage, faster operation and the potential for minimally invasive application. DESIGN A Medline literature search was performed on vessel welding combined with cross-referencing. RESULTS Four different lasers have mostly been used for LAVA, always in combination with stay sutures. The CO(2) laser has only been used in the early period. Without solder, mean leaking point pressures (LPP) of 754 mmHg (n=75) were obtained, only slightly lower than in suture controls (LPP=915 mmHg, n=82). At follow-up the percentage of aneurysms was high (overall 12% in n=486). Although Argon LAVA showed moderate success (LPP=146 mmHg, n=125), the first clinical application has been successfully performed. Diode LAVA in combination with solder and dye resulted in an acceptable LPP of 409 mmHg (n=163) in larger vessels, with a low incidence of aneurysm formation (1% in n=107). CONCLUSION At present the diode laser is the most popular. Solder developments resulted in stronger welds and might make stay sutures redundant. The combination of CO(2) laser and solders has not been evaluated and deserves further investigation.
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Oskoui P, Stadler I, Lanzafame RJ. A preliminary study of laser tissue soldering as arterial wall reinforcement in an acute experimental aneurysm model. Lasers Surg Med 2003; 32:346-8. [PMID: 12766956 DOI: 10.1002/lsm.10173] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Aneurysm formation results from destruction of structural arterial wall connective tissue, leading to wall weakening and rupture. The purpose of this study was to demonstrate that reinforcement of the arterial wall using laser tissue soldering contributes to arterial wall stabilization and rupture prevention in an acute experimental model. STUDY DESIGN/MATERIALS AND METHODS Elastase (10 U/mg protein, Sigma-Aldrich Co., St. Louis, MO) was applied with a fine paint brush on femoral artery segments to cause fusiform aneurysm formation. After aneurysms formed (approximately 45 minutes after treatment), elastase was rinsed out and indocyanine green (ICG) and albumin soldering mixture (2.5 mg/ml ICG in 50% albumin) was delivered to the arterial segment, followed by laser irradiation at 830 nm, (15mW output for 20 minutes). In situ pressure burst measurements were then performed. RESULTS In situ burst pressures were > 503 mmHg for normal arteries and 181 +/- 26.0 mmHg, for Elastase treated segments. (P < 0.0001) Treatment of experimental aneurysms laser tissue soldering returned burst strengths to > 503 mmHg. CONCLUSIONS These results indicate laser tissue soldering reinforcement of weak arterial walls, is possible and may reduce the likelihood of acute rupture. Further development of this technique for aneurysm management is warranted.
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Affiliation(s)
- Philip Oskoui
- The Laser Center and Department of Surgery, Rochester General Hospital, Rochester, New York 14621, USA
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Tiwari A, Cheng KS, Salacinski H, Hamilton G, Seifalian AM. Improving the patency of vascular bypass grafts: the role of suture materials and surgical techniques on reducing anastomotic compliance mismatch. Eur J Vasc Endovasc Surg 2003; 25:287-95. [PMID: 12651165 DOI: 10.1053/ejvs.2002.1810] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND compliance mismatch is an important factor in the development of myointimal hyperplasia in both coronary and vascular anastomoses. This mismatch may be reduced by the use of newer suture materials and techniques. This review discusses the current techniques and materials used to date in generating anastomoses in both coronary and vascular applications and to correlate these with the degree of inherent compliance achieved. METHODS PubMed, ISIS, CAS and PAS database searches were performed. Other articles were cross-referenced. RESULTS AND CONCLUSION continuous suture is still the most used technique in both cardiac and vascular surgery for the generation of anastomoses due to the reduced time and improved haemostasis. However, continuous suture results in a greater compliance mismatch than the interrupted technique. Vein cuffs and patches improve compliance and transmission of pulsatile blood flow and offer improvement of graft patency. Alternative to sutures are biological glue, clips and laser generated solders all of which have shown promising results, but further work is required before they become applicable for routine use.
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Affiliation(s)
- A Tiwari
- Tissue Engineering Centre, University Department of Surgery, Royal Free and University College Medical School, University College London and The Royal Free Hospital, London, UK
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Abstract
OBJECTIVES solders containing chromophores and proteins enhance the strength of lasered anastomoses. Methylene blue (MB) solder anastomoses in vitro are strong but no in vivo work has been reported. We used an MB solder in vivo and studied the effects of two laser powers on patency and histological appearance. DESIGN, MATERIALS AND METHODS two groups of 15 rabbits had unilateral end-to-end carotid anastomoses (1.5-2.0 mm) formed using three stay sutures and MB solder. Group 1 anastomoses were formed at 5.7 Wcm(-1) and Group 2 at 2.8 Wcm(-1). The vessels were examined at various points by necropsy for patency and gross macroscopic appearance, with subsequent histological examination. RESULTS group 2 showed patency of 93.3% v 0% ( p<0.001) endothelialisation of 100% v 26.6% ( p<0.001), giant cell formation 0% v 40.0% ( p<0.01), but stenosis was not significantly different (0% v 13.3% p=0.06). Group 2 showed a higher rate of intimal hyperplasia (IH) (66.6% v 20.0% p<0.05) but neither group exhibited thermal injury or aneurysm formation. CONCLUSIONS laser soldered microvascular anastomoses were formed in vessels of 1.5-2.0 mm with a high degree of patency. A relationship appears to exist between laser power and anastomotic patency. Methylene blue fading has the potential to act as a switch against over exposure and a visual indicator of solder activation.
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Affiliation(s)
- J F Birch
- Department of Plastic Surgery, Salisbury District Hospital, UK
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Talmor M, Bleustein CB, Poppas DP. Laser tissue welding: a biotechnological advance for the future. ARCHIVES OF FACIAL PLASTIC SURGERY 2001; 3:207-13. [PMID: 11497508 DOI: 10.1001/archfaci.3.3.207] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Laser tissue welding as well as other alternative methods of closure will play a more important role in surgical specialties as laparoscopic, endoscopic, and microsurgical techniques continue to develop. Laser tissue welding uses laser energy to anastomose tissues and is ideally suited for applications in which suturing and stapling is difficult. Recent advances have led to a better understanding of the mechanisms of tissue welding. Additionally, technical achievements including the introduction of protein solders and temperature-controlled feedback systems have led to the acceptance of laser tissue welding in clinical medicine. In this article, we describe the history and development of laser tissue welding and review the current and potential applications of this technology.
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Affiliation(s)
- M Talmor
- Center for Pediatric Urology, Children's Hospital of New York, New York Presbyterian Hospital-Weill Medical College of Cornell University, 525 E 68th St, Box 94, New York, NY 10021, USA
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Bleustein CB, Sennett M, Kung RT, Felsen D, Poppas DP, Stewart RB. Differential scanning calorimetry of albumin solders: interspecies differences and fatty acid binding effects on protein denaturation. Lasers Surg Med 2001; 27:465-70. [PMID: 11126440 DOI: 10.1002/1096-9101(2000)27:5<465::aid-lsm1007>3.0.co;2-s] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVE Understanding albumin solder denaturation is important for laser tissue soldering. Human (HSA), bovine (BSA), porcine (PSA), and canine (CSA) albumin both fatty acid containing (FAC) and fatty acid free (FAF) were evaluated by using differential scanning calorimetry (DSC). STUDY DESIGN/MATERIALS AND METHODS DSC was used to measure difference thermograms to determine the irreversible thermal denaturation profile for 50% albumin solutions. The denaturation transition's onset, end and peak temperatures, and enthalpy were measured. RESULTS All FAC species, except BSA, exhibited twin peaked endotherms. Single endotherms were observed for all FAF species and BSA-FAC. Onset and end temperatures were significantly [P < 0.001] lower for all FAF species (except BSA's end temperature). There was a 30% decrease in the denaturation enthalpy between FAF and FAC groups. CONCLUSION FAF albumin solders were found to denature at significantly lower temperatures, while also having a 30% reduction in enthalpy when compared with their FAC counterparts.
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Affiliation(s)
- C B Bleustein
- Center for Pediatric Urology, Department of Urology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York 10021, USA
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