Initial results of endothelial cell seeding following argon laser carotid endarterectomy

Neointimal hyperplasia following argon ion laser carotid endarterectomy: with and without endothelial cell seeding

BACKGROUND AND OBJECTIVE

This study compares the development of neointimal hyperplasia following conventional and argon ion laser carotid endarterectomy and assesses the potential advantage of endothelial cell seeding.

STUDY DESIGN/MATERIALS AND METHODS

Eight dogs underwent conventional endarterectomy in one carotid artery and an argon ion laser endarterectomy in the other. After 42 days, these arteries were harvested and the intimal thickness were compared. Six additional dogs underwent bilateral argon ion laser carotid endarterectomy with endothelial cell seeding on the one side only. These arteries were harvested after 65 days and their mean intimal thickness were compared.

RESULTS

At 42 days, the mean intimal thickness in the conventional endarterectomy group was 0.070 +/- 0.007 mm; in the argon ion laser endarterectomy group it was 0.058 +/- 0.001 mm (P = 0.76, NS). At 65 days, the mean intimal thickness in the group without endothelial cell seeding was 0.125 +/- 0.003 mm vs. 0.061 +/- 0.001 mm on the seeded side (P = 0.043).

CONCLUSION

Argon ion laser carotid endarterectomy results in no more neointimal hyperplasia than conventional endarterectomy. The neointimal hyperplasia is reduced by endothelial cell seeding.

Endothelial cell seeding of de-endothelialised human arteries: improvement by adhesion molecule induction and flow-seeding technology

OBJECTIVES

To assess re-endothelialisation of denuded human arteries by two different seeding techniques using adhesion molecule induction and a dynamic flow-seeding.

DESIGN

Prospective, open study.

SETTING

University Department of Cardiovascular Surgery.

MATERIALS AND METHODS

In the first group (I) segments of human common carotid arteries (n = 4) were balloon-denuded, short-time seeded with cultured adult human venous endothelial cells (EC) and exposed to a mock circulation. In the second group (II) (n = 4), EC were incubated with a synthetic RGD peptide (arginine-glycine-aspartate) prior to seeding with the aim of upregulating the cellular adhesion molecules and increasing EC attachment. In the third group (III) (n = 4), EC were seeded not using the common technique of instillating cells and sequentially rotating the graft but by a dynamic flow application. The percentage of EC-covered luminal surface was assessed by image analysis of scanning electron micrographs.

RESULTS

EC attachment was significantly increased in groups II (73%) and III (94%) compared with group I (34%). In group III, a preconfluent monolayer could be established immediately after seeding. One hour of artificial perfusion resulted in no significant EC loss in any of the study groups.

CONCLUSIONS

RGD-peptide preincubation improves EC seeding of biological surfaces. Because of accelerated seeding times it may have good potential for clinical applications. The flow-seeding technology may be indispensable if EC seeding of the vascular surface of complete organ systems is required.