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Kim WJ, Samarage HM, Jafari M, Zarrin D, Goel K, Qi X, Wang AC, Johnson J, Colby GP. Novel endovascular transmural technique for pharmacological block of superior cervical ganglion prevents sympathetic-mediated cerebral vasospasm. J Neurointerv Surg 2024; 16:770-774. [PMID: 37500479 PMCID: PMC10818000 DOI: 10.1136/jnis-2023-020636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Sympathetic-mediated vasoconstriction from the superior cervical ganglion (SCG) is a significant contributor to cerebral vasospasm. Inhibition of the SCG has been shown to improve cerebral blood flow and reverse cerebral vasospasm in swine models. We evaluated the efficacy of a novel minimally invasive endovascular approach to target and pharmacologically inhibit the SCG, using a Micro-Infusion Device for transmural drug delivery. METHODS Eight SCGs in four Yorkshire swine were surgically identified. After confirming appropriate sympathetic-mediated intracranial vasoconstriction response with SCG stimulation, an endovascular Micro-Infusion Device was used for transmural targeting of the SCG and delivery of 1.5-2 mL of 1% lidocaine-contrast mixture to the perivascular space. Digital subtraction angiography was obtained at: (1) baseline; (2) with SCG stimulation; and (3) after lidocaine delivery to the SCG using the Micro-Infusion Device with concurrent SCG stimulation. Vessel diameters were measured and compared. RESULTS Endovascular transmural delivery of lidocaine to the SCG and carotid perivascular tissue using the Micro-Infusion Device successfully inhibited sympathetic-mediated vasoconstriction response. Measured vessel diameters after lidocaine delivery were comparable to baseline despite SCG stimulation. CONCLUSION A novel endovascular technique of transmural delivery of lidocaine to the SCG and carotid artery perivascular tissues successfully inhibits the sympathetic input to the cerebral vasculature and modulates sympathetic-mediated cerebral vasospasm. These results suggest promising steps towards translation to potential clinical use for patients suffering from cerebral vasospasm.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Matiar Jafari
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- University of California Los Angeles, Los Angeles, California, USA
| | - Xin Qi
- School of Medicine, UCLA, Los Angeles, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
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2
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Haderer LM, Zhou Y, Tang P, Daneshgar A, Globke B, Krenzien F, Reutzel-Selke A, Weinhart M, Pratschke J, Sauer IM, Hillebrandt KH, Keshi E. Thrombogenicity assessment of perfusable tissue engineered constructs: a systematic review. TISSUE ENGINEERING. PART B, REVIEWS 2024. [PMID: 39007511 DOI: 10.1089/ten.teb.2024.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Vascular surgery faces a critical demand for novel vascular grafts that are biocompatible and thromboresistant. This urgency particularly applies to bypass operations involving small caliber vessels. In the realm of tissue engineering, the development of fully vascularized organs holds great promise as a solution to organ shortage for transplantation. To achieve this, it is imperative to (re-)construct a biocompatible and non-thrombogenic vascular network within these organs. In this systematic review, we identify, classify and discuss basic principles and methods used to perform in vitro/ex vivo dynamic thrombogenicity testing of perfusable tissue engineered organs and tissues. We conducted a pre-registered systematic review of studies published in the last 23 years according to PRISMA-P Guidelines, comprising a systematic data extraction, in-depth analysis and risk of bias assessment of 116 included studies. We identified shaking (n=28), flow loop (n=17), ex vivo (arterio-venous shunt, n=33) and dynamic in vitro models (n=38) as main approaches for thrombogenicity assessment. This comprehensive review unveils a prevalent lack of standardization and serves as a valuable guide in the design of standardized experimental setups.
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Affiliation(s)
| | - Yijun Zhou
- Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany;
| | - Peter Tang
- Charité - Campus Virchow, General-, Visceral-, and Transplantation Surgery, Berlin, Germany;
| | - Assal Daneshgar
- Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany;
| | - Brigitta Globke
- Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany;
| | - Felix Krenzien
- Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany;
| | - Anja Reutzel-Selke
- Charité - Campus Virchow, General-, Visceral-, and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany, 13353;
| | | | - Johann Pratschke
- Charité - Universitätsmedizin Berlin, General, Visceral, and Transplantation Surgery, Berlin, Germany;
| | - Igor M Sauer
- Charité, General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany, 13353;
| | - Karl Herbert Hillebrandt
- Charité - Campus Virchow, General-, Visceral-, and Transplantation Surgery, Augstenburgerplatz 1, Berlin, Germany, 13353;
| | - Eriselda Keshi
- Charité Universitätsmedizin Berlin, Chirurgische Klinik, Augustenburger Platz 1, Berlin, Germany, 13353;
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3
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Lin L, Chen L, Chen G, Lu C, Hong FF. Effects of heterogeneous surface characteristics on hemocompatibility and cytocompatibility of bacterial nanocellulose. Carbohydr Polym 2024; 335:122063. [PMID: 38616074 DOI: 10.1016/j.carbpol.2024.122063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024]
Abstract
The surface properties of cardiovascular biomaterials play a critical role in their biological responses. Although bacterial nanocellulose (BNC) materials have exhibited potential applications in cardiovascular implants, the impact of their surface characteristics on biocompatibility has rarely been studied. This study investigated the mechanism for the biocompatibility induced by the physicochemical properties of both sides of BNC. With greater wettability and smoothness, the upper BNC surface reduced protein adsorption by 25 % compared with the lower surface. This prolonged the plasma re-calcification time by 14 % in venous blood. Further, compared with the lower BNC surface, the upper BNC surface prolonged the activated partial thromboplastin time by 5 % and 4 % in arterial and venous blood, respectively. Moreover, the lower BNC surface with lesser rigidity, higher roughness, and sparser fiber structure promoted cell adhesion. The lower BNC surface enhanced the proliferation rate of L929 and HUVECs cells by 15 % and 13 %, respectively, compared with the upper BNC surface. With lesser stiffness, the lower BNC surface upregulated the expressions of CD31 and eNOS while down-regulating the ICAM-1 expression - This promoted the proliferation of HUVECs. The findings of this study will provide valuable insights into the design of blood contact materials and cardiovascular implants.
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Affiliation(s)
- Lulu Lin
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China; College of Biological Science and Medical Engineering, Donghua University, Shanghai, China; National Advanced Functional Fiber Innovation Center, Wu Jiang, Su Zhou, China; Scientific Research Base of Bacterial Nanofiber Manufacturing and Composite Technology, China Textile Engineering Society, China
| | - Lin Chen
- College of Biological Science and Medical Engineering, Donghua University, Shanghai, China; Scientific Research Base of Bacterial Nanofiber Manufacturing and Composite Technology, China Textile Engineering Society, China
| | - Genqiang Chen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China; College of Biological Science and Medical Engineering, Donghua University, Shanghai, China.
| | - Changrui Lu
- College of Biological Science and Medical Engineering, Donghua University, Shanghai, China
| | - Feng F Hong
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China; College of Biological Science and Medical Engineering, Donghua University, Shanghai, China; National Advanced Functional Fiber Innovation Center, Wu Jiang, Su Zhou, China; Scientific Research Base of Bacterial Nanofiber Manufacturing and Composite Technology, China Textile Engineering Society, China.
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4
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Hernandez-Sanchez D, Comtois-Bona M, Muñoz M, Ruel M, Suuronen EJ, Alarcon EI. Manufacturing and validation of small-diameter vascular grafts: A mini review. iScience 2024; 27:109845. [PMID: 38799581 PMCID: PMC11126982 DOI: 10.1016/j.isci.2024.109845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
The field of small-diameter vascular grafts remains a challenge for biomaterials scientists. While decades of research have brought us much closer to developing biomimetic materials for regenerating tissues and organs, the physiological challenges involved in manufacturing small conduits that can transport blood while not inducing an immune response or promoting blood clots continue to limit progress in this area. In this short review, we present some of the most recent methods and advancements made by researchers working in the field of small-diameter vascular grafts. We also discuss some of the most critical aspects biomaterials scientists should consider when developing lab-made small-diameter vascular grafts.
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Affiliation(s)
- Deyanira Hernandez-Sanchez
- BioEngineering and Therapeutic Solutions (BEaTS) Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
| | - Maxime Comtois-Bona
- BioEngineering and Therapeutic Solutions (BEaTS) Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
| | - Marcelo Muñoz
- BioEngineering and Therapeutic Solutions (BEaTS) Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
| | - Marc Ruel
- BioEngineering and Therapeutic Solutions (BEaTS) Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
- Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, 451 Smyth Road, Ottawa ON K1H8M5, Canada
| | - Erik J. Suuronen
- BioEngineering and Therapeutic Solutions (BEaTS) Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, 451 Smyth Road, Ottawa ON K1H8M5, Canada
| | - Emilio I. Alarcon
- BioEngineering and Therapeutic Solutions (BEaTS) Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y4W7, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H8M5, Canada
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5
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Van Hecke M, Langenaeken T, Rega F, Roskams T, Meuris B. Validation of large animal models in mechanical valve research: a histologic comparison. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2024; 38:ivae070. [PMID: 38637938 PMCID: PMC11078892 DOI: 10.1093/icvts/ivae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/15/2024] [Accepted: 04/17/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES Mechanical valves still require life-long anticoagulation. Preclinical animal testing is a crucial step in the assessment of valves; however, the chosen animal model should be carefully considered, and a well-controlled animal model of mechanical valve thrombosis has not been established yet. In this study, a histopathologic comparison was performed to evaluate the representativity of pigs and sheep as large animal models in bileaflet mechanical valve thrombosis research. METHODS 10 pigs and 8 sheep were implanted with a bileaflet mechanical valve in pulmonary position. During follow-up, no anticoagulative therapy was administered. Pigs were sacrificed between 14 and 38 days for explantation and assessment of the valve. Sheep were sacrificed between 71 and 155 days. Thrombus samples were processed and (immuno)histochemical stainings were applied. A pathologist evaluated the samples morphologically and semiquantitatively and compared these samples to available slides from 3 human patients who underwent redo surgery for acute bileaflet mechanical valve thrombosis, caused by insufficient anticoagulation. RESULTS All pigs showed macroscopically evident thrombi on the mechanical valve surface at sacrifice. In contrast, none of the sheep showed any sign of thrombus formation. Histology showed a high fibrin content in thrombi of both human and porcine cases (3/3 vs 8/10). Porcine thrombi showed more cellular organization (0/3 vs 6/10), more calcification (0/3 vs 9/10) and more endothelialization (0/3 vs 6/10). Inflammatory cells were present in all samples and were considered physiological. CONCLUSIONS Contrary to sheep, pigs develop thrombi on their mechanical valves in the short-term if no anticoagulation is administered. Histologic comparison of human and porcine thrombi shows comparable findings. The pig model might serve interestingly for further research on valve thrombosis, if it shows not to be an overly aggressive model.
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Affiliation(s)
- Manon Van Hecke
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Tom Langenaeken
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Filip Rega
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Tania Roskams
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Meuris
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
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6
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Jiang S, Wise SG, Kovacic JC, Rnjak-Kovacina J, Lord MS. Biomaterials containing extracellular matrix molecules as biomimetic next-generation vascular grafts. Trends Biotechnol 2024; 42:369-381. [PMID: 37852854 DOI: 10.1016/j.tibtech.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023]
Abstract
The performance of synthetic biomaterial vascular grafts for the bypass of stenotic and dysfunctional blood vessels remains an intractable challenge in small-diameter applications. The functionalization of biomaterials with extracellular matrix (ECM) molecules is a promising approach because these molecules can regulate multiple biological processes in vascular tissues. In this review, we critically examine emerging approaches to ECM-containing vascular graft biomaterials and explore opportunities for future research and development toward clinical use.
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Affiliation(s)
- Shouyuan Jiang
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - Steven G Wise
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, Sydney, NSW 2006, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia; The University of Sydney Nano Institute, University of Sydney, Sydney, NSW 2006, Australia
| | - Jason C Kovacic
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW 2010, Australia; St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW 2010, Australia; Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jelena Rnjak-Kovacina
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - Megan S Lord
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2052, Australia.
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7
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Nguyen VA, Brooks-Richards TL, Ren J, Woodruff MA, Allenby MC. Quantitative and large-format histochemistry to characterize peripheral artery compositional gradients. Microsc Res Tech 2023; 86:1642-1654. [PMID: 37602569 DOI: 10.1002/jemt.24400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/06/2023] [Indexed: 08/22/2023]
Abstract
The femoropopliteal artery (FPA) is a long, flexible vessel that travels down the anteromedial compartment of the thigh as the femoral artery and then behind the kneecap as the popliteal artery. This artery undergoes various degrees of flexion, extension, and torsion during normal walking movements. The FPA is also the most susceptible peripheral artery to atherosclerosis and is where peripheral artery disease manifests in 80% of cases. The connection between peripheral artery location, its mechanical flexion, and its physiological or pathological biochemistry has been investigated for decades; however, histochemical methods remain poorly leveraged in their ability to spatially correlate normal or abnormal extracellular matrix and cells with regions of mechanical flexion. This study generates new histological image processing pipelines to quantitate tissue composition across high-resolution FPA regions-of-interest or low-resolution whole-section cross-sections in relation to their anatomical locations and flexions during normal movement. Comparing healthy ovine femoral, popliteal, and cranial-tibial artery sections as a pilot, substantial arterial contortion was observed in the distal popliteal and cranial tibial regions of the FPA which correlated with increased vascular smooth muscle cells and decreased elastin content. These methods aim to aid in the quantitative characterization of the spatial distribution of extracellular matrix and cells in large heterogeneous tissue sections such as the FPA. RESEARCH HIGHLIGHTS: Large-format histology preserves artery architecture. Elastin and smooth muscle content is correlated with distance from heart and contortion during flexion. Cell and protein analyses are sensitive to sectioning plane and image magnification.
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Affiliation(s)
- V A Nguyen
- School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - T L Brooks-Richards
- School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - J Ren
- School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - M A Woodruff
- School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - M C Allenby
- School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Chemical Engineering, University of Queensland (UQ), Brisbane, Queensland, Australia
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8
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West-Livingston L, Lim JW, Lee SJ. Translational tissue-engineered vascular grafts: From bench to bedside. Biomaterials 2023; 302:122322. [PMID: 37713761 DOI: 10.1016/j.biomaterials.2023.122322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023]
Abstract
Cardiovascular disease is a primary cause of mortality worldwide, and patients often require bypass surgery that utilizes autologous vessels as conduits. However, the limited availability of suitable vessels and the risk of failure and complications have driven the need for alternative solutions. Tissue-engineered vascular grafts (TEVGs) offer a promising solution to these challenges. TEVGs are artificial vascular grafts made of biomaterials and/or vascular cells that can mimic the structure and function of natural blood vessels. The ideal TEVG should possess biocompatibility, biomechanical mechanical properties, and durability for long-term success in vivo. Achieving these characteristics requires a multi-disciplinary approach involving material science, engineering, biology, and clinical translation. Recent advancements in scaffold fabrication have led to the development of TEVGs with improved functional and biomechanical properties. Innovative techniques such as electrospinning, 3D bioprinting, and multi-part microfluidic channel systems have allowed the creation of intricate and customized tubular scaffolds. Nevertheless, multiple obstacles must be overcome to apply these innovations effectively in clinical practice, including the need for standardized preclinical models and cost-effective and scalable manufacturing methods. This review highlights the fundamental approaches required to successfully fabricate functional vascular grafts and the necessary translational methodologies to advance their use in clinical practice.
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Affiliation(s)
- Lauren West-Livingston
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA; Department of Vascular and Endovascular Surgery, Duke University, Durham, NC, 27712, USA
| | - Jae Woong Lim
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA; Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital, Bucheon-Si, Gyeonggi-do, 420-767, Republic of Korea
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
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Simard T, Jung R, Di Santo P, Sarathy K, Majeed K, Motazedian P, Short S, Dhaliwal S, Labinaz A, Sarma D, Ramirez FD, Froeschl M, Labinaz M, Holmes DR, Alkhouli M, Hibbert B. Evaluation of a Rabbit Model of Vascular Stent Healing: Application of Optical Coherence Tomography. J Cardiovasc Transl Res 2023; 16:1194-1204. [PMID: 37227686 DOI: 10.1007/s12265-023-10399-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/10/2023] [Indexed: 05/26/2023]
Abstract
Percutaneous coronary intervention (PCI) is a management strategy for symptomatic obstructive coronary artery disease (CAD). Despite advancements, in-stent restenosis (ISR) still imparts a 1-2% annual rate of repeat revascularization-a focus of ongoing translational research. Optical coherence tomography (OCT) provides high resolution virtual histology of stents. Our study evaluates the use of OCT for virtual histological assessment of stent healing in a rabbit aorta model, enabling complete assessment of intraluminal healing throughout the stent. ISR varies based on intra-stent location, stent length, and stent type in a rabbit model-important considerations for translational experimental design. Atherosclerosis leads to more prominent ISR proliferation independent of stent-related factors. The rabbit stent model mirrors clinical observations, while OCT-based virtual histology demonstrates utility for pre-clinical stent assessment. Pre-clinical models should incorporate clinical and stent factors as feasible to maximize translation to clinical practice.
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Affiliation(s)
- Trevor Simard
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
| | - Richard Jung
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
| | - Pietro Di Santo
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Kiran Sarathy
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
- Department of Cardiology, Prince of Wales Hospital, Sydney, Australia
| | - Kamran Majeed
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
| | - Pouya Motazedian
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Spencer Short
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Shan Dhaliwal
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Alisha Labinaz
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Dhruv Sarma
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - F Daniel Ramirez
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Michael Froeschl
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - Marino Labinaz
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada
| | - David R Holmes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Alkhouli
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Benjamin Hibbert
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada.
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada.
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10
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Kim WJ, Samarage HM, Zarrin D, Goel K, Wang AC, Johnson J, Nael K, Colby GP. Endovascular transmural access to carotid artery perivascular tissues: safety assessment of a novel technique. J Neurointerv Surg 2023; 15:1007-1013. [PMID: 36319086 PMCID: PMC10149561 DOI: 10.1136/jnis-2022-019583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recent advances in endovascular devices have allowed access and targeting of perivascular tissues of the peripheral circulation. The perivascular tissues of the cervical and cranial circulations have many important structures of clinical significance, yet the feasibility and safety of such an approach has not been demonstrated. OBJECTIVE To evaluate the safety of a novel endovascular transmural approach to target the perivascular tissues of the common carotid artery in swine. METHODS A micro-infusion device was positioned in the carotid arteries of three Yorkshire pigs (six carotid arteries in total), and each carotid artery was punctured 10 times in the same location to gain access to the perivascular tissues. Digital subtraction angiography was used to evaluate vessel injury or contrast extravasation. MRI and MR angiography were used to evaluate evidence of cerebral ischemia or vessel injury. Post-mortem tissue analysis was performed to assess the level of extravascular hematoma and intravascular dissection. RESULTS None of the tested carotid arteries showed evidence of vessel injury (dissection or perforation) or intravascular thrombosis. MRI performed after repeated puncture was negative for neck hematoma and brain ischemia. Post-mortem tissue analysis of the carotid arteries showed mild adventitial staining with blood, but without associated hematoma and without vessel dissection. CONCLUSION Repeated puncture of the carotid artery to gain access to the perivascular tissues using a novel endovascular transmural approach is safe in a swine model. This represents a novel approach to various tissues in close proximity to the cervical and cranial vasculature.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Kambiz Nael
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
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11
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Klein D, Heller L, Sorkin A, Zeltzer AA. Evaluation of a novel anastomotic device in the animal model: A feasibility, safety, and efficacy study. J Plast Reconstr Aesthet Surg 2023; 85:479-487. [PMID: 37598589 DOI: 10.1016/j.bjps.2023.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/24/2023] [Accepted: 07/16/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND A novel device was designed to assist with microvascular arterial anastomoses. This study compares the safety and efficacy of the anastomosis-assisting device with manual suturing in an ovine model. METHODS Arteries with a diameter ranging from 2 to 4 mm were transected and anastomosed at four locations. A comparison was done between manual anastomoses and anastomoses performed with a novel anastomotic device in seven sheep. All the device-assisted anastomoses were performed by a single surgeon. At day 45 ± 7, anastomotic sites were dissected to determine patency, and samples were obtained for pathology. RESULTS Thirteen of 13 (100%) samples from the Vesseal™ group demonstrated patency both on the day the anastomoses were performed and after the 45-day follow-up period. All four additional anastomoses performed using the Vesseal™ were found patent. In the hand-suturing group, six of six (100%) samples demonstrated patency on the day of the anastomoses and five of six (83%) were patent after the follow-up period. No thromboses or adverse events were observed in the anastomoses in either group. No difference in histopathology of the anastomoses was observed between the groups. CONCLUSIONS The anastomosis-assisting device is a safe and efficacious alternative to hand suturing. The patency rates of device-assisted anastomoses were greater than those of manual suturing and pose no additional risk, as demonstrated by clinical observation, histopathology, and macroscopic evaluation. The Vesseal™ anastomosis-assisting device may be a viable alternative to manual suturing, with an ergonomic and intuitive design, short learning curve, and consistent results.
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Affiliation(s)
- Doron Klein
- Department of Plastic and Reconstructive Surgery, Shamir Medical Center, Zerifin 70300, Israel.
| | - Lior Heller
- Department of Plastic and Reconstructive Surgery, Shamir Medical Center, Zerifin 70300, Israel
| | - Alex Sorkin
- Department of Plastic and Reconstructive Surgery, Shamir Medical Center, Zerifin 70300, Israel
| | - Assaf A Zeltzer
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa, Israel
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12
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Kirkton RD, Watson JDB, Houston R, Prichard HL, Niklason LE, Rasmussen TE. Evaluation of vascular repair by tissue-engineered human acellular vessels or expanded polytetrafluoroethylene grafts in a porcine model of limb ischemia and reperfusion. J Trauma Acute Care Surg 2023; 95:234-241. [PMID: 36943014 PMCID: PMC10389495 DOI: 10.1097/ta.0000000000003974] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/24/2023] [Accepted: 03/12/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND This study evaluated performance of a tissue-engineered human acellular vessel (HAV) in a porcine model of acute vascular injury and ischemia. The HAV is an engineered blood vessel consisted of human vascular extracellular matrix proteins. Limb reperfusion and vascular outcomes of the HAV were compared with those from synthetic expanded polytetrafluoroethylene (ePTFE) grafts. METHODS Thirty-six pigs were randomly assigned to four treatment groups, receiving either the HAV or a PTFE graft following a hind limb ischemia period of either 0 or 6 hours. All grafts were 3-cm-long interposition 6-mm diameter grafts implanted within the right iliac artery. Animals were not immunosuppressed and followed for up to 28 days after surgery. Assessments performed preoperatively and postoperatively included evaluation of graft patency, hind limb function, and biochemical markers of tissue ischemia or reperfusion injury. Histological analysis was performed on explants to assess host cell responses. RESULTS Postoperative gait assessment and biochemical analysis confirmed that ischemia and reperfusion injury were caused by 6-hour ischemia, regardless of vascular graft type. Hind limb function and tissue damage biomarkers improved in all groups postoperatively. Final patency rates at postoperative day 28 were higher for HAV than for ePTFE graft in both the 0-hour (HAV, 85.7%; ePTFE, 66.7%) and 6-hour (HAV, 100%; ePTFE, 75%) ischemia groups, but these differences were not statistically significant. Histological analyses identified some intimal hyperplasia and host reactivity to the xenogeneic HAV and also to the synthetic ePTFE graft. Positive host integration and vascular cell infiltration were identified in HAV but not ePTFE explants. CONCLUSION Based on the functional performance and the histologic profile of explanted HAVs, this study supports further investigation to evaluate long-term performance of the HAV when used to repair traumatic vascular injuries.
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13
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Settembrini A, Buongiovanni G, Settembrini P, Alessandrino A, Freddi G, Vettor G, Martelli E. In-vivo evaluation of silk fibroin small-diameter vascular grafts: state of art of preclinical studies and animal models. Front Surg 2023; 10:1090565. [PMID: 37304180 PMCID: PMC10254405 DOI: 10.3389/fsurg.2023.1090565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Autologous vein and artery remains the first choice for vascular grafting procedures in small-diameter vessels such as coronary and lower limb districts. Unfortunately, these vessels are often found to be unsuitable in atherosclerotic patients due to the presence of calcifications or to insufficient size. Synthetic grafts composed of materials such as expanded polytetrafluoroethylene (ePTFE) are frequently employed as second choice, because of their widespread availability and success in the reconstruction of larger arteries. However, ePTFE grafts with small diameter are plagued by poor patency rates due to surface thrombogenicity and intimal hyperplasia, caused by the bioinertness of the synthetic material and aggravated by low flow conditions. Several bioresorbable and biodegradable polymers have been developed and tested to exploit such issues for their potential stimulation to endothelialization and cell infiltration. Among these, silk fibroin (SF) has shown promising pre-clinical results as material for small-diameter vascular grafts (SDVGs) because of its favorable mechanical and biological properties. A putative advantage in graft infection in comparison with synthetic materials is plausible, although it remains to be demonstrated. Our literature review will focus on the performance of SF-SDVGs in vivo, as evaluated by studies performing vascular anastomosis and interposition procedures, within small and large animal models and different arterial districts. Efficiency under conditions that more accurately mime the human body will provide encouraging evidence towards future clinical applications.
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Affiliation(s)
- Alberto Settembrini
- Department of Vascular Surgery, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Buongiovanni
- Postgraduate School of Vascular Surgery, Università Degli Studi di Milano, Milan, Italy
| | - Piergiorgio Settembrini
- Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | | | | | - Giulia Vettor
- Heart Rhythm Center, Department of Clinical Electrophysiology and Cardiac Pacing, IRCCS Monzino Cardiology Center, Milan, Italy
| | - Eugenio Martelli
- Department of General and Specialist Surgery, Sapienza University of Rome, Rome, Italy
- Saint Camillus International University of Health Sciences, Rome, Italy
- Division of Vascular Surgery, S. Anna and S. Sebastiano Hospital, Caserta, Italy
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14
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Sameti M, Shojaee M, Saleh BM, Moore LK, Bashur CA. Peritoneal pre-conditioning impacts long-term vascular graft patency and remodeling. BIOMATERIALS ADVANCES 2023; 148:213386. [PMID: 36948108 DOI: 10.1016/j.bioadv.2023.213386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/13/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
There are questions about how well small-animal models for tissue-engineered vascular grafts (TEVGs) translate to clinical patients. Most TEVG studies used grafting times ≤6 months where conduits from generally biocompatible materials like poly(ε-caprolactone) (PCL) perform well. However, longer grafting times can result in significant intimal hyperplasia and calcification. This study tests the hypothesis that differences in pro-inflammatory response from pure PCL conduits will be consequential after long-term grafting. It also tests the long-term benefits of a peritoneal pre-implantation strategy on rodent outcomes. Electrospun conduits with and without peritoneal pre-implantation, and with 0 % and 10 % (w/w) collagen/PCL, were grafted into abdominal aortae of rats for 10 months. This study found that viability of control grafts without pre-implantation was reduced unlike prior studies with shorter grafting times, confirming the relevance of this model. Importantly, pre-implanted grafts had a 100 % patency rate. Further, pre-implantation reduced intimal hyperplasia within the graft. Differences in response between pure PCL and collagen/PCL conduits were observed (e.g., fewer CD80+ and CD3+ cells for collagen/PCL), but only pre-implantation had an effect on the overall graft viability. This study demonstrates how long-term grafting in rodent models can better evaluate viability of different TEVGs, and the benefits of the peritoneal pre-implantation step.
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Affiliation(s)
- Mahyar Sameti
- Department of Biomedical, Chemical Engineering, and Science, Florida Institute of Technology, Melbourne, FL 32901, United States
| | - Mozhgan Shojaee
- Department of Biomedical, Chemical Engineering, and Science, Florida Institute of Technology, Melbourne, FL 32901, United States
| | - Bayan M Saleh
- Department of Biomedical, Chemical Engineering, and Science, Florida Institute of Technology, Melbourne, FL 32901, United States
| | - Lisa K Moore
- Department of Biomedical, Chemical Engineering, and Science, Florida Institute of Technology, Melbourne, FL 32901, United States
| | - Chris A Bashur
- Department of Biomedical, Chemical Engineering, and Science, Florida Institute of Technology, Melbourne, FL 32901, United States.
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15
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Van Hecke M, Van Hoof L, Sikole M, Mufty H, Claus P, Verbrugghe P, Ely J, Berg GA, Roskams T, Meuris B. A Large-Diameter Vascular Graft Replacing Animal-Derived Sealants With an Elastomeric Polymer. J Surg Res 2023; 284:6-16. [PMID: 36527768 DOI: 10.1016/j.jss.2022.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/25/2022] [Accepted: 11/20/2022] [Indexed: 12/16/2022]
Abstract
INTRODUCTION To assess the safety and efficacy of an experimental large-diameter vascular graft externally sealed with an elastomeric polymer when used as an interposition graft in the descending aorta of sheep. METHODS The experimental vascular grafts as well as control gelatin sealed interposition grafts were inserted into the descending aorta of juvenile sheep. The grafts were assessed by time to hemostasis and blood loss during surgery and hematology and biochemistry panels at distinct time points. Magnetic resonance imaging (MRI) was performed at 3 and at 6 mo after surgery, after which the animals were euthanized and necropsies were carried out including macroscopic and microscopic examination of the grafts, anastomoses, and distal organs. RESULTS All animals survived the study period. There was no perceivable difference in the surgical handling of the grafts. The median intraoperative blood loss was 27.5 mL (range 10.0-125.0 mL) in the experimental group and 50.0 mL (range 10.0-75.0 mL) in the control group. The median time to hemostasis was 5.0 min (range 2.0-16.0 min) minutes in the experimental group versus 6.0 min (range 4.0-6.0 min) in the control group. MRI showed normal flow and graft patency in both groups. Healing and perianastomotic endothelialization was similar in both groups. CONCLUSIONS The experimental graft has a similar safety and performance profile and largely comparable necropsy results, in comparison to a commonly used prosthetic vascular graft, with the experimental grafts eliciting a nonadherent external fibrous capsule as the major difference compared to the control grafts that were incorporated into the periadventitia. Survival, hemostatic sealing, and hematologic and radiologic results were comparable between the study groups.
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Affiliation(s)
- Manon Van Hecke
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium.
| | - Lucas Van Hoof
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Magdalena Sikole
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hozan Mufty
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Piet Claus
- KU Leuven, Department of Cardiovascular Sciences, Cardiovascular Imaging and Dynamics, Leuven, Belgium
| | - Peter Verbrugghe
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - John Ely
- RUA Life Sciences, Irvine, United Kingdom
| | | | - Tania Roskams
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Meuris
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
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16
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Ratner B. Vascular Grafts: Technology Success/Technology Failure. BME FRONTIERS 2023; 4:0003. [PMID: 37849668 PMCID: PMC10521696 DOI: 10.34133/bmef.0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/15/2022] [Indexed: 10/19/2023] Open
Abstract
Vascular prostheses (grafts) are widely used for hemodialysis blood access, trauma repair, aneurism repair, and cardiovascular reconstruction. However, smaller-diameter (≤4 mm) grafts that would be valuable for many reconstructions have not been achieved to date, although hundreds of papers on small-diameter vascular grafts have been published. This perspective article presents a hypothesis that may open new research avenues for the development of small-diameter vascular grafts. A historical review of the vascular graft literature and specific types of vascular grafts is presented focusing on observations important to the hypothesis to be presented. Considerations in critically reviewing the vascular graft literature are discussed. The hypothesis that perhaps the "biocompatible biomaterials" comprising our vascular grafts-biomaterials that generate dense, nonvascularized collagenous capsules upon implantation-may not be all that biocompatible is presented. Examples of materials that heal with tissue reconstruction and vascularity, in contrast to the fibrotic encapsulation, are offered. Such prohealing materials may lead the way to a new generation of vascular grafts suitable for small-diameter reconstructions.
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Affiliation(s)
- Buddy Ratner
- Center for Dialysis Innovation (CDI), Departments of Bioengineering and Chemical Engineering, University of Washington, Seattle, WA 98195, USA
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17
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Ding X, Zhang W, Xu P, Feng W, Tang X, Yang X, Wang L, Li L, Huang Y, Ji J, Chen D, Liu H, Fan Y. The Regulatory Effect of Braided Silk Fiber Skeletons with Differential Porosities on In Vivo Vascular Tissue Regeneration and Long-Term Patency. RESEARCH (WASHINGTON, D.C.) 2022; 2022:9825237. [PMID: 36474603 PMCID: PMC9703915 DOI: 10.34133/2022/9825237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/11/2022] [Indexed: 06/21/2024]
Abstract
The development of small-diameter vascular grafts that can meet the long-term patency required for implementation in clinical practice presents a key challenge to the research field. Although techniques such as the braiding of scaffolds can offer a tunable platform for fabricating vascular grafts, the effects of braided silk fiber skeletons on the porosity, remodeling, and patency in vivo have not been thoroughly investigated. Here, we used finite element analysis of simulated deformation and compliance to design vascular grafts comprised of braided silk fiber skeletons with three different degrees of porosity. Following the synthesis of low-, medium-, and high-porosity silk fiber skeletons, we coated them with hemocompatible sulfated silk fibroin sponges and then evaluated the mechanical and biological functions of the resultant silk tubes with different porosities. Our data showed that high-porosity grafts exhibited higher elastic moduli and compliance but lower suture retention strength, which contrasted with low-porosity grafts. Medium-porosity grafts offered a favorable balance of mechanical properties. Short-term in vivo implantation in rats indicated that porosity served as an effective means to regulate blood leakage, cell infiltration, and neointima formation. High-porosity grafts were susceptible to blood leakage, while low-porosity grafts hindered graft cellularization and tended to induce intimal hyperplasia. Medium-porosity grafts closely mimicked the biomechanical behaviors of native blood vessels and facilitated vascular smooth muscle layer regeneration and polarization of infiltrated macrophages to the M2 phenotype. Due to their superior performance and lack of occlusion, the medium-porosity vascular grafts were evaluated in long-term (24-months) in vivo implantation. The medium-porosity grafts regenerated the vascular smooth muscle cell layers and collagen extracellular matrix, which were circumferentially aligned and resembled the native artery. Furthermore, the formed neoarteries pulsed synchronously with the adjacent native artery and demonstrated contractile function. Overall, our study underscores the importance of braided silk fiber skeleton porosity on long-term vascular graft performance and will help to guide the design of next-generation vascular grafts.
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Affiliation(s)
- Xili Ding
- School of Engineering Medicine, Beihang University, Beijing 100083, China
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Weirong Zhang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Peng Xu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Wentao Feng
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Xiaokai Tang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Xianda Yang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Lizhen Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Linhao Li
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Yan Huang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Jing Ji
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Diansheng Chen
- eRobot Institute, School of Mechanical Engineering and Automation, Beihang University, Beijing 100083, China
| | - Haifeng Liu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Yubo Fan
- School of Engineering Medicine, Beihang University, Beijing 100083, China
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
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18
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Ono M, Kageyama S, O’Leary N, El-Kurdi MS, Reinöhl J, Solien E, Bianco RW, Doss M, Meuris B, Virmani R, Cox M, Onuma Y, Serruys PW. 1-Year Patency of Biorestorative Polymeric Coronary Artery Bypass Grafts in an Ovine Model. JACC. BASIC TO TRANSLATIONAL SCIENCE 2022; 8:19-34. [PMID: 36777172 PMCID: PMC9911320 DOI: 10.1016/j.jacbts.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022]
Abstract
Many attempts have been made to inhibit or counteract saphenous vein graft (SVG) failure modes; however, only external support for SVGs has gained momentum in clinical utility. This study revealed the feasibility of implantation, and showed good patency out to 12 months of the novel biorestorative graft, in a challenging ovine coronary artery bypass graft model. This finding could trigger the first-in-man trial of using the novel material instead of SVG. We believe that, eventually, this novel biorestorative bypass graft can be one of the options for coronary artery bypass graft patients who have difficulty harvesting SVG.
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Key Words
- CABG, coronary artery bypass grafting
- CPB, cardiopulmonary bypass
- IH, intimal hyperplasia
- LAD, left anterior descending artery
- OCT, optical coherence tomography
- QCA, quantitative coronary angiography
- QFR, quantitative flow ratio
- RVG, restorative vascular graft
- SVG, saphenous vein graft
- coronary artery bypass graft
- coronary artery disease
- coronary revascularization
- ePTFE, expanded polytetrafluoroethylene
- polymeric bypass graft
- preclinical model
- quantitative flow ratio
- restorative vascular graft
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Affiliation(s)
- Masafumi Ono
- Amsterdam Universitair Medische Centra, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Shigetaka Kageyama
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Neil O’Leary
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | | | | | - Eric Solien
- American Preclinical Services, LLC, Minneapolis, Minnesota, USA
| | - Richard W. Bianco
- Experimental Surgical Services, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mirko Doss
- Department of Cardiac Surgery, Helios Clinic, Siegburg, Germany
| | - Bart Meuris
- Department of Cardiac Surgery, University Hospital Leuven, Leuven, Belgium
| | - Renu Virmani
- CVPath Institute, Inc, Gaithersburg, Maryland, USA
| | | | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Patrick W. Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
- NHLI, Imperial College London, London, United Kingdom
- Address for correspondence: Dr Patrick W. Serruys, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
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19
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Fusco D, Meissner F, Podesser BK, Marsano A, Grapow M, Eckstein F, Winkler B. Small-diameter bacterial cellulose-based vascular grafts for coronary artery bypass grafting in a pig model. Front Cardiovasc Med 2022; 9:881557. [PMID: 36225961 PMCID: PMC9548626 DOI: 10.3389/fcvm.2022.881557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022] Open
Abstract
Surgical revascularization is the gold standard in most cases of complex coronary artery disease. For coronary artery bypass grafting, autologous grafts are state-of-the-art due to their long-term patency. A non-negligible amount of patients lack suitable bypass material as a result of concomitant diseases or previous interventions. As a promising alternative, tissue-engineered vascular grafts made of biomaterials such as bacterial cellulose (BC) are gaining more and more attention. However, the production of small-diameter grafts (inner diameter < 6 mm) of application-oriented length (> 5 cm) and their in vivo long-term patency remain challenging. In this study, grafts of 20 cm in length with an inner diameter of 3 mm were generated in a custom-made bioreactor. To potentially improve graft compliance and, therefore in vivo patency, BC was combined with an embedded cobalt–chromium mesh. The grafts were designed for in vivo endothelialization and specific surgical properties and implanted as an aortocoronary bypass in a left anterior descending occluded pig model (n = 8). Coronary angiography showed complete patency postoperatively at 4 weeks. Following 4 weeks in vivo, the grafts were explanted revealing a three-layered wall structure. Grafts were colonized by smooth muscle cells and a luminal layer of endothelial cells with early formation of vasa privata indicating functional remodeling. These encouraging findings in a large animal model reveal the great potential of small-diameter BC grafts for coronary and peripheral bypass grafting.
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Affiliation(s)
- Deborah Fusco
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
| | - Florian Meissner
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
| | - Bruno K. Podesser
- Center for Biomedical Research, Medical University Vienna, Vienna, Austria
| | - Anna Marsano
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
| | - Martin Grapow
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
- Heart Center Hirslanden Zurich, Zurich, Switzerland
| | - Friedrich Eckstein
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
| | - Bernhard Winkler
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
- Center for Biomedical Research, Medical University Vienna, Vienna, Austria
- Department of Cardiovascular Surgery, Vienna Heart Center KFL, Vienna, Austria
- *Correspondence: Bernhard Winkler,
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20
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Yu Y, Appadoo V, Ren J, Hacker TA, Liu B, Lynn DM. pH-Responsive Polyelectrolyte Coatings that Enable Catheter-Mediated Transfer of DNA to the Arterial Wall in Short and Clinically Relevant Inflation Times. ACS Biomater Sci Eng 2022; 8:4377-4389. [PMID: 36121432 DOI: 10.1021/acsbiomaterials.2c00707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report the design and characterization of pH-responsive polymer coatings that enable catheter balloon-mediated transfer of DNA to arterial tissue in short, clinically relevant inflation times. Our approach exploits the pH-dependent ionization of poly(acrylic acid) (PAA) to promote disassembly and release of plasmid DNA from polyelectrolyte multilayers. We characterized the contact transfer of multilayers composed of PAA, plasmid DNA, and linear poly(ethyleneimine) (LPEI) identified as promising in prior studies on the delivery of DNA to arterial tissue. In contrast to thinner films evaluated previously, we found thicker coatings composed of 32 repeating (LPEI/PAA/LPEI/DNA)x tetralayers to swell substantially in physiologically relevant media (in PBS; pH = 7.4). In some cases, these coatings also disintegrated or delaminated rapidly from their underlying substrates, suggesting the potential for enhanced balloon-mediated transfer. We developed a technically straightforward agarose gel-based hole-insertion model to characterize factors (inflation time, lumen size, etc.) that influence contact transfer of DNA when film-coated balloons are inflated into contact with soft surfaces. Those studies and the results of in vivo experiments using small animal (rat) and large animal (pig) models of peripheral arterial injury revealed catheters coated with these materials to promote robust contact transfer of DNA to soft hydrogel surfaces and the luminal surfaces of arterial tissue using inflation times as short as 30 s. These short inflation times are relevant in the context of clinical vascular interventions in peripheral arteries. Additional studies demonstrated that contact transfer of DNA using these short times can promote subsequent dissemination and transport of DNA to the medial tissue layer, suggesting the potential for use in therapeutically relevant applications of balloon-mediated gene transfer.
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Affiliation(s)
- Yan Yu
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, 1415 Engineering Drive, Madison, Wisconsin 53706, United States
| | - Visham Appadoo
- Department of Chemistry, University of Wisconsin-Madison, 1101 University Ave., Madison, Wisconsin 53706, United States
| | - Jun Ren
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, Wisconsin 53705, United States
| | - Timothy A Hacker
- Cardiovascular Research Center, University of Wisconsin-Madison, 600 Highland Ave., Madison, Wisconsin 53792, United States
| | - Bo Liu
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, Wisconsin 53705, United States
| | - David M Lynn
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, 1415 Engineering Drive, Madison, Wisconsin 53706, United States.,Department of Chemistry, University of Wisconsin-Madison, 1101 University Ave., Madison, Wisconsin 53706, United States
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21
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Li J, Zhuo N, Zhang J, Sun Q, Si J, Wang K, Zhi D. The loading of C-type natriuretic peptides improved hemocompatibility and vascular regeneration of electrospun poly(ε-caprolactone) grafts. Acta Biomater 2022; 151:304-316. [PMID: 36002127 DOI: 10.1016/j.actbio.2022.08.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 11/01/2022]
Abstract
As a result of thrombosis or intimal hyperplasia, synthetic artificial vascular grafts had a low success rate when they were used to replace small-diameter arteries (inner diameter < 6 mm). C-type natriuretic peptides (CNP) have anti-thrombotic effects, and can promote endothelial cell (EC) proliferation and inhibit vascular smooth muscle cell (SMC) over-growth. In this study, poly(ε-caprolactone) (PCL) vascular grafts loaded with CNP (PCL-CNP) were constructed by electrospinning. The PCL-CNP grafts were able to continuously release CNP at least 25 days in vitro. The results of scanning electron microscopy (SEM) and mechanical testing showed that the loading of CNP did not change the microstructure and mechanical properties of the PCL grafts. In vitro blood compatibility analysis displayed that PCL-CNP grafts could inhibit thrombin activity and reduce platelet adhesion and activation. In vitro cell experiments demonstrated that PCL-CNP grafts activated ERK1/2 and Akt signaling in human umbilical vein endothelial cells (HUVECs), as well as increased cyclin D1 expression, enhanced proliferation and migration, and increased vascular endothelial growth factor (VEGF) secretion and nitric oxide (NO) production. The rabbit arteriovenous (AV)-shunt ex vitro indicated that CNP loading significantly improved the antithrombogenicity of PCL grafts. The assessment of vascular grafts in rat abdominal aorta implantation model displayed that PCL-CNP grafts promoted the regeneration of ECs and contractile SMCs, modulated macrophage polarization toward M2 phenotype, and enhanced extracellular matrix remodeling. These findings confirmed for the first time that loading CNP is an effective approach to improve the hemocompatibility and vascular regeneration of synthetic vascular grafts. STATEMENT OF SIGNIFICANCE: : Small-diameter (< 6 mm) vascular grafts (SDVGs) have not been made clinically available due to their prevalence of thrombosis, limited endothelial regeneration and intimal hyperplasia. The incorporation of bioactive molecules into SDVGs serves as an effective solution to improve hemocompatibility and endothelialization. In this study, for the first time, we loaded C-type natriuretic peptides (CNP) into PCL grafts by electrospunning and confirmed the effectiveness of loading CNP on improving the hemocompatibility and vascular regeneration of artificial vascular grafts. Regenerative advantages included enhancement of endothelialization, modulation of macrophage polarization toward M2 phenotypes, and improved contractile smooth muscle cell regeneration. Our investigation brings attention to CNP as a valuable bioactive molecule for modifying cardiovascular biomaterial.
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Affiliation(s)
- Jing Li
- Department of Ultrasound, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
| | - Na Zhuo
- Department of Ultrasound, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Jingai Zhang
- College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Qiqi Sun
- College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Jianghua Si
- College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Kai Wang
- College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Dengke Zhi
- College of Life Sciences, Nankai University, Tianjin 300071, China.
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22
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Biodegradable external wrapping promotes favorable adaptation in an ovine vein graft model. Acta Biomater 2022; 151:414-425. [PMID: 35995404 DOI: 10.1016/j.actbio.2022.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022]
Abstract
Vein grafts, the most commonly used conduits in multi-vessel coronary artery bypass grafting surgery, have high intermediate- and long-term failure rates. The abrupt and marked increase in hemodynamic loads on the vein graft is a known contributor to failure. Recent computational modeling suggests that veins can more successfully adapt to an increase in mechanical load if the rate of loading is gradual. Applying an external wrap or support at the time of surgery is one way to reduce the transmural load, and this approach has improved performance relative to an unsupported vein graft in several animal studies. Yet, a clinical trial in humans has shown benefits and drawbacks, and mechanisms by which an external wrap affects vein graft adaptation remain unknown. This study aims to elucidate such mechanisms using a multimodal experimental and computational data collection pipeline. We quantify morphometry using magnetic resonance imaging, mechanics using biaxial testing, hemodynamics using computational fluid dynamics, structure using histology, and transcriptional changes using bulk RNA-sequencing in an ovine carotid-jugular interposition vein graft model, without and with an external biodegradable wrap that allows loads to increase gradually. We show that a biodegradable external wrap promotes luminal uniformity, physiological wall shear stress, and a consistent vein graft phenotype, namely, it prevents over-distension, over-thickening, intimal hyperplasia, and inflammation, and it preserves mechanotransduction. These mechanobiological insights into vein graft adaptation in the presence of an external support can inform computational growth and remodeling models of external support and facilitate design and manufacturing of next-generation external wrapping devices. STATEMENT OF SIGNIFICANCE: External mechanical support is emerging as a promising technology to prevent vein graft failure following coronary bypass graft surgery. While variants of this technology are currently under investigation in clinical trials, the fundamental mechanisms of adaptation remain poorly understood. We employ an ovine carotid-jugular interposition vein graft model, with and without an external biodegradable wrap to provide mechanical support, and probe vein graft adaptation using a multimodal experimental and computational data collection pipeline. We quantify morphometry using magnetic resonance imaging, mechanics using biaxial testing, fluid flow using computational fluid dynamics, vascular composition and structure using histology, and transcriptional changes using bulk RNA sequencing. We show that the wrap mitigates vein graft failure by promoting multiple adaptive mechanisms (across biological scales).
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23
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Caldiroli A, Pederzani E, Pezzotta M, Azzollini N, Fiori S, Tironi M, Rizzo P, Sangalli F, Figliuzzi M, Fiore GB, Remuzzi A, Riboldi SA, Soncini M, Redaelli A. Hybrid fibroin/polyurethane small-diameter vascular grafts: from fabrication to in vivo preliminary assessment. Biomed Mater 2022; 17. [PMID: 35944550 DOI: 10.1088/1748-605x/ac885a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 08/08/2022] [Indexed: 11/12/2022]
Abstract
To address the need of alternatives to autologous vessels for small-calibre vascular applications (e.g. cardiac surgery), a hybrid semi-degradable material composed of silk fibroin and polyurethane (Silkothane®) was herein used to fabricate very small-calibre grafts (innner diameter = 1.5 mm) via electrospinning. Hybrid grafts were in vitro characterized in terms of morphology and mechanical behaviour, and compared to similar grafts of pure silk fibroin. Similarly, two native vessels from a rodent model (abdominal aorta and vena cava) were harvested and characterized. Preliminary implants were performed on Lewis rats to confirm the suitability of Silkothane® grafts for small-calibre applications, specifically as aortic insertion and femoral shunt. The manufacturing process generated pliable grafts consisting of a randomized fibrous mesh and exhibiting similar geometrical features to rat aortas. Both Silkothane® and pure silk fibroin grafts showed radial compliances in the range from 1.37 ± 0.86 to 1.88 ± 1.01 % 10-2 mmHg-1, lower than that of native vessels. The Silkothane® small-calibre devices were also implanted in rats demonstrating to be adequate for vascular applications; all the treated rats survived the surgery for 3 months after implantation, and 16 rats out of 17 (94%) still showed blood flow inside the graft at sacrifice. The obtained results lay the basis for a deeper investigation of the interaction between the Silktohane® graft and the implant site, which may deal with further analysis on the potentialities in terms of degradability and tissue formation, on longer time-points.
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Affiliation(s)
- Alice Caldiroli
- Bioengineering Laboratories Srl, Via Vivaldi 32/A, Cantù, 22063, ITALY
| | - Elia Pederzani
- Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Ponzio 34, Milano, Lombardia, 20133, ITALY
| | - Marco Pezzotta
- Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Ponzio 34, Milano, Lombardia, 20133, ITALY
| | - Nadia Azzollini
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS , Via Stezzano 87, Bergamo, 24126, ITALY
| | - Sonia Fiori
- , Istituto di ricerche farmacologiche mario negri IRCCS, via Stezzano 87, Bergamo, Lombardia, 24126, ITALY
| | - Matteo Tironi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS , Via Stezzano 87, Bergamo, 24126, ITALY
| | - Paola Rizzo
- IRCCS Istituto di Ricerche Farmacologiche Mario Negri Centro Anna Maria Astori, via Stezzano 87, Bergamo, 24126, ITALY
| | - Fabio Sangalli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via Stezzano 87, Bergamo, 24126, ITALY
| | - Marina Figliuzzi
- Bioengineering, Istituto di ricerche farmacologiche mario negri IRCCS, via Stezzano 87, Bergamo, Bergamo, 24126, ITALY
| | - Gianfranco Beniamino Fiore
- Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Ponzio, 34, Milano, Lombardia, 20133, ITALY
| | - Andrea Remuzzi
- Università degli Studi di Bergamo, Via Pignolo 123, Bergamo, Lombardia, 24121, ITALY
| | | | - Monica Soncini
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza L Da Vinci ,32, Milano, 20133, ITALY
| | - Alberto Redaelli
- Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Ponzio 34, Milano, 20133, ITALY
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24
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Taha A, Bobi J, Dammers R, Dijkhuizen RM, Dreyer AY, van Es ACGM, Ferrara F, Gounis MJ, Nitzsche B, Platt S, Stoffel MH, Volovici V, Del Zoppo GJ, Duncker DJ, Dippel DWJ, Boltze J, van Beusekom HMM. Comparison of Large Animal Models for Acute Ischemic Stroke: Which Model to Use? Stroke 2022; 53:1411-1422. [PMID: 35164533 PMCID: PMC10962757 DOI: 10.1161/strokeaha.121.036050] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Translation of acute ischemic stroke research to the clinical setting remains limited over the last few decades with only one drug, recombinant tissue-type plasminogen activator, successfully completing the path from experimental study to clinical practice. To improve the selection of experimental treatments before testing in clinical studies, the use of large gyrencephalic animal models of acute ischemic stroke has been recommended. Currently, these models include, among others, dogs, swine, sheep, and nonhuman primates that closely emulate aspects of the human setting of brain ischemia and reperfusion. Species-specific characteristics, such as the cerebrovascular architecture or pathophysiology of thrombotic/ischemic processes, significantly influence the suitability of a model to address specific research questions. In this article, we review key characteristics of the main large animal models used in translational studies of acute ischemic stroke, regarding (1) anatomy and physiology of the cerebral vasculature, including brain morphology, coagulation characteristics, and immune function; (2) ischemic stroke modeling, including vessel occlusion approaches, reproducibility of infarct size, procedural complications, and functional outcome assessment; and (3) implementation aspects, including ethics, logistics, and costs. This review specifically aims to facilitate the selection of the appropriate large animal model for studies on acute ischemic stroke, based on specific research questions and large animal model characteristics.
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Affiliation(s)
- Aladdin Taha
- Division of Experimental Cardiology, Department of Cardiology (A.T., J.B., D.J.D., H.M.M.v.B.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Stroke Center (A.T., D.W.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Joaquim Bobi
- Division of Experimental Cardiology, Department of Cardiology (A.T., J.B., D.J.D., H.M.M.v.B.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Ruben Dammers
- Department of Neurosurgery, Stroke Center (R.D., V.V.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht, Utrecht University, the Netherlands (R.M.D.)
| | - Antje Y Dreyer
- Max Planck Institute for Infection Biology, Campus Charité Mitte, Berlin, Germany (A.Y.D.)
| | - Adriaan C G M van Es
- Department of Radiology, Leiden University Medical Center, the Netherlands (A.C.G.M.v.E.)
| | - Fabienne Ferrara
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany (F.F.)
| | - Matthew J Gounis
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester (M.J.G.)
| | - Björn Nitzsche
- Institute of Anatomy, Faculty of Veterinary Medicine (B.N.), University of Leipzig, Germany
- Department of Nuclear Medicine (B.N.), University of Leipzig, Germany
| | - Simon Platt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens (S.P.)
| | - Michael H Stoffel
- Division of Veterinary Anatomy, Vetsuisse Faculty, University of Bern, Switzerland (M.H.S.)
| | - Victor Volovici
- Department of Neurosurgery, Stroke Center (R.D., V.V.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Gregory J Del Zoppo
- Division of Hematology (G.J.d.Z.), University of Washington School of Medicine, Seattle
- Department of Medicine (G.J.d.Z.), University of Washington School of Medicine, Seattle
- Department of Neurology (G.J.d.Z.), University of Washington School of Medicine, Seattle
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology (A.T., J.B., D.J.D., H.M.M.v.B.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Diederik W J Dippel
- Department of Neurology, Stroke Center (A.T., D.W.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Johannes Boltze
- School of Life Sciences, Faculty of Science, University of Warwick, Coventry, United Kingdom (J.B.)
| | - Heleen M M van Beusekom
- Division of Experimental Cardiology, Department of Cardiology (A.T., J.B., D.J.D., H.M.M.v.B.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
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25
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Kubo Y, Yamashita K, Saito T, Tanaka K, Makino T, Takahashi T, Kurokawa Y, Yamasaki M, Eguchi H, Doki Y, Nakajima K. Heparinized swine models for better surgical/endoscopic training. DEN OPEN 2022; 2:e64. [PMID: 35310757 PMCID: PMC8828249 DOI: 10.1002/deo2.64] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Yuto Kubo
- Department of Next‐Generation Endoscopic Intervention (Project ENGINE) Center of Medical Innovation and Translational Research, Graduate School of Medicine, Osaka University Osaka Japan
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Kotaro Yamashita
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Takuro Saito
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Koji Tanaka
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Tomoki Makino
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Tsuyoshi Takahashi
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Makoto Yamasaki
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
| | - Kiyokazu Nakajima
- Department of Next‐Generation Endoscopic Intervention (Project ENGINE) Center of Medical Innovation and Translational Research, Graduate School of Medicine, Osaka University Osaka Japan
- Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan
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26
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Zhi D, Cheng Q, Midgley AC, Zhang Q, Wei T, Li Y, Wang T, Ma T, Rafique M, Xia S, Cao Y, Li Y, Li J, Che Y, Zhu M, Wang K, Kong D. Mechanically reinforced biotubes for arterial replacement and arteriovenous grafting inspired by architectural engineering. SCIENCE ADVANCES 2022; 8:eabl3888. [PMID: 35294246 PMCID: PMC8926343 DOI: 10.1126/sciadv.abl3888] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
There is a lack in clinically-suitable vascular grafts. Biotubes, prepared using in vivo tissue engineering, show potential for vascular regeneration. However, their mechanical strength is typically poor. Inspired by architectural design of steel fiber reinforcement of concrete for tunnel construction, poly(ε-caprolactone) (PCL) fiber skeletons (PSs) were fabricated by melt-spinning and heat treatment. The PSs were subcutaneously embedded to induce the assembly of host cells and extracellular matrix to obtain PS-reinforced biotubes (PBs). Heat-treated medium-fiber-angle PB (hMPB) demonstrated superior performance when evaluated by in vitro mechanical testing and following implantation in rat abdominal artery replacement models. hMPBs were further evaluated in canine peripheral arterial replacement and sheep arteriovenous graft models. Overall, hMPB demonstrated appropriate mechanics, puncture resistance, rapid hemostasis, vascular regeneration, and long-term patency, without incidence of luminal expansion or intimal hyperplasia. These optimized hMPB properties show promise as an alternatives to autologous vessels in clinical applications.
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Affiliation(s)
- Dengke Zhi
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Quhan Cheng
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Adam C. Midgley
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Qiuying Zhang
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Tingting Wei
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Yi Li
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Ting Wang
- Urban Transport Emission Control Research Centre, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Tengzhi Ma
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Muhammad Rafique
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Shuang Xia
- Department of Radiology, Tianjin Key Disciplines of Radiology, Tianjin First Central Hospital, Nankai University, Tianjin 300192, China
| | - Yuejuan Cao
- Department of Vascular Surgery, Tianjin Union Medical Center, Nankai University, Tianjin 300121, China
| | - Yangchun Li
- Department of Vascular Surgery, Tianjin Union Medical Center, Nankai University, Tianjin 300121, China
| | - Jing Li
- Department of Ultrasound, Tianjin Union Medical Center, Nankai University, Tianjin 300121, China
| | - Yongzhe Che
- Department of Pathology and Anatomy, School of Medicine, Nankai University, Tianjin 300071, China
| | - Meifeng Zhu
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
- Corresponding author. (D.K.); (K.W.); (M.Z.)
| | - Kai Wang
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
- Corresponding author. (D.K.); (K.W.); (M.Z.)
| | - Deling Kong
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
- Institute of Transplant Medicine, Tianjin First Central Hospital, Nankai University, Tianjin 300192, China
- Corresponding author. (D.K.); (K.W.); (M.Z.)
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27
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Ovine Iliac Vein Model for Endovascular Thrombectomy of Acute Deep Venous Thrombosis. J Vasc Interv Radiol 2022; 33:249-254.e1. [PMID: 35221045 DOI: 10.1016/j.jvir.2021.10.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022] Open
Abstract
An ovine iliac vein thrombosis model was devised to test a wall-contacting rotational thrombectomy device. Thrombosis was successfully induced in 9 sheep with an average clot length of 31 mm ± 12 and >60% vessel occlusion on angiography. The thrombus was subsequently removed, maintaining normal intraoperative pulmonary arterial pressure (5.9 mm Hg ± 3.6) and complete distal reperfusion after thrombectomy. Additionally, the sheep were without signs of vascular trauma or embolic complications on gross necropsy and histopathologic analysis. The findings from this study support the use of an ovine iliac deep vein thrombosis model for testing of a lower extremity thrombectomy device.
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28
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Koch SE, de Kort BJ, Holshuijsen N, Brouwer HFM, van der Valk DC, Dankers PYW, van Luijk JAKR, Hooijmans CR, de Vries RBM, Bouten CVC, Smits AIPM. Animal studies for the evaluation of in situ tissue-engineered vascular grafts - a systematic review, evidence map, and meta-analysis. NPJ Regen Med 2022; 7:17. [PMID: 35197483 PMCID: PMC8866508 DOI: 10.1038/s41536-022-00211-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/11/2022] [Indexed: 12/12/2022] Open
Abstract
Vascular in situ tissue engineering (TE) is an approach that uses bioresorbable grafts to induce endogenous regeneration of damaged blood vessels. The evaluation of newly developed in situ TE vascular grafts heavily relies on animal experiments. However, no standard for in vivo models or study design has been defined, hampering inter-study comparisons and translational efficiency. To provide input for formulating such standard, the goal of this study was to map all animal experiments for vascular in situ TE using off-the-shelf available, resorbable synthetic vascular grafts. A literature search (PubMed, Embase) yielded 15,896 studies, of which 182 studies met the inclusion criteria (n = 5,101 animals). The reports displayed a wide variety of study designs, animal models, and biomaterials. Meta-analysis on graft patency with subgroup analysis for species, age, sex, implantation site, and follow-up time demonstrated model-specific variations. This study identifies possibilities for improved design and reporting of animal experiments to increase translational value.
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Affiliation(s)
- Suzanne E Koch
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bente J de Kort
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Noud Holshuijsen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Hannah F M Brouwer
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Dewy C van der Valk
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Patricia Y W Dankers
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Judith A K R van Luijk
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Carlijn R Hooijmans
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Anthal I P M Smits
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. .,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands.
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29
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Yao Y, Jeong Y, Zaw AM, Kukumberg M, Yim EKF. Rabbit Surgery Protocol for End-to-End and End-to-Side Vascular Graft Anastomosis. Methods Mol Biol 2022; 2375:177-189. [PMID: 34591308 DOI: 10.1007/978-1-0716-1708-3_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Preclinical testing in animal model is a required stage of vascular device development. Among small animal models, rabbits provide vasculature with relative larger caliber for anastomotic implantation of vascular grafts as preclinical testing before conducting large animal studies. Rabbits have similar hemostatic mechanism with human and can accommodate vascular grafts with various diameters at different locations, and thus provide a valid model to assess small-diameter vascular grafts. This chapter will describe the procedures and materials required to conduct survival surgery in rabbit carotid artery models for implantation of small-diameter tubular grafts with an end-to-side and end-to-end anastomotic technique.
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Affiliation(s)
- Yuan Yao
- Regenerative Nanomedicine Lab, Department of Chemical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - YeJin Jeong
- Regenerative Nanomedicine Lab, Department of Chemical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Aung Moe Zaw
- Regenerative Nanomedicine Lab, Department of Chemical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Marek Kukumberg
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Tissue Regeneration and Repair Laboratory, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Evelyn K F Yim
- Regenerative Nanomedicine Lab, Department of Chemical Engineering, University of Waterloo, Waterloo, ON, Canada.
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Gruzdeva OV, Bychkova EE, Penskaya TY, Kuzmina AA, Antonova LV, Barbarash LS. Comparative Analysis of the Hemostasiological Profile in Sheep and Patients with Cardiovascular Pathology as the Basis for Predicting Thrombotic Risks During Preclinical Tests of Vascular Prostheses. Sovrem Tekhnologii Med 2021; 13:52-56. [PMID: 34513066 PMCID: PMC8353693 DOI: 10.17691/stm2021.13.1.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of the investigation was to study the details of hemostasiological profile in sheep and patients with coronary heart disease (CHD) and to find the possibility of predicting thrombotic risks during preclinical tests of vascular prostheses on a large laboratory animal model.
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Affiliation(s)
- O V Gruzdeva
- Head of the Laboratory of Homeostasis Research, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - E E Bychkova
- Research Assistant, Laboratory of Homeostasis Research, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - T Yu Penskaya
- Junior Researcher, Laboratory of Homeostasis Research, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - A A Kuzmina
- Junior Researcher, Laboratory of Homeostasis Research, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - L V Antonova
- Head of the Laboratory of Cell Technologies, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - L S Barbarash
- Professor, Academician of the Russian Academy of Sciences, Chief Researcher, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
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Bacterial Nanocellulose-Based Grafts for Cell Colonization Studies: An In Vitro Bioreactor Perfusion Model. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2021; 2436:205-222. [PMID: 34505267 DOI: 10.1007/7651_2021_417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
With the aging population, the demand for artificial small diameter vascular grafts is constantly increasing, as the availability of autologous grafts is limited due to vascular diseases. A confluent lining with endothelial cells is considered to be a cornerstone for long-term patency of artificial small diameter grafts. We use bacterial nanocellulose off-the-shelf grafts and describe a detailed methodology to study the ability of these grafts to re-colonize with endothelial cells in an in vitro bioreactor model. The viability of the constructs generated in this process was investigated using established cell culture and tissue engineering methods, which includes WST-1 proliferation assay, AcLDL uptake assay, lactate balancing and histological characterization. The data generated this straight forward methodology allow an initial assessment of the principal prospects of success in forming a stable endothelium in artificial vascular prostheses.
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Håkansson J, Simsa R, Bogestål Y, Jenndahl L, Gustafsson-Hedberg T, Petronis S, Strehl R, Österberg K. Individualized tissue-engineered veins as vascular grafts: A proof of concept study in pig. J Tissue Eng Regen Med 2021; 15:818-830. [PMID: 34318614 DOI: 10.1002/term.3233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/22/2021] [Accepted: 07/22/2021] [Indexed: 11/06/2022]
Abstract
Personalized tissue engineered vascular grafts are a promising advanced therapy medicinal product alternative to autologous or synthetic vascular grafts utilized in blood vessel bypass or replacement surgery. We hypothesized that an individualized tissue engineered vein (P-TEV) would make the body recognize the transplanted blood vessel as autologous, decrease the risk of rejection and thereby avoid lifelong treatment with immune suppressant medication as is standard with allogenic organ transplantation. To individualize blood vessels, we decellularized vena cava from six deceased donor pigs and tested them for cellular removal and histological integrity. A solution with peripheral blood from the recipient pigs was used for individualized reconditioning in a perfusion bioreactor for seven days prior to transplantation. To evaluate safety and functionality of the individualized vascular graft in vivo, we transplanted reconditioned porcine vena cava into six pigs and analyzed histology and patency of the graft at different time points, with three pigs at the final endpoint 4-5 weeks after surgery. Our results showed that the P-TEV was fully patent in all animals, did not induce any occlusion or stenosis formation and we did not find any signs of rejection. The P-TEV showed rapid recellularization in vivo with the luminal surface covered with endothelial cells. In summary, the results indicate that P-TEV is functional and have potential for use as clinical transplant grafts.
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Affiliation(s)
- Joakim Håkansson
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, Borås, Sweden.,Laboratory Medicine, Biomedicine, Gothenburg University, Gothenburg, Sweden
| | | | - Yalda Bogestål
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, Borås, Sweden
| | | | | | - Sarunas Petronis
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, Borås, Sweden
| | | | - Klas Österberg
- Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg, Sweden
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Mufty H, Van Den Eynde J, Meuris B, Metsemakers WJ, Van Wijngaerden E, Vandendriessche T, Steenackers HP, Fourneau I. Pre-clinical in vivo Models of Vascular Graft Coating in the Prevention of Vascular Graft Infection: A Systematic Review. Eur J Vasc Endovasc Surg 2021; 62:99-118. [PMID: 33840577 DOI: 10.1016/j.ejvs.2021.02.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 01/26/2021] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Vascular graft infection (VGI) remains an important complication with a high mortality and morbidity rate. Currently, studies focusing on the role of vascular graft coatings in the prevention of VGI are scarce. Therefore, the aims of this study were to survey and summarise key features of pre-clinical in vivo models that have been used to investigate coating strategies to prevent VGI and to set up an ideal model that can be used in future preclinical research. DATA SOURCES A systematic review was conducted in accordance with the Preferred reporting items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search was performed in MEDLINE (PubMed), Embase, and Web of Science. REVIEW METHODS For each database, a specific search strategy was developed. Quality was assessed with the Toxicological data Reliability Assessment Tool (ToxRTool). The type of animal model, graft, coating, and pathogen were summarised. The outcome assessment in each study was evaluated. RESULTS In total, 4 667 studies were identified, of which 94 papers focusing on in vivo testing were included. Staphylococcus aureus was the organism most used (n = 65; 67.7%). Most of the graft types were polyester grafts. Rifampicin was the most frequently used antibiotic coating (n = 43, 48.3%). In the outcome assessment, most studies mentioned colony forming unit count (n = 88; 91.7%) and clinical outcome (n = 72; 75%). According to the ToxRTool, 21 (22.3%, n = 21/94) studies were considered to be not reliable. CONCLUSION Currently published in vivo models are very miscellaneous. More attention should be paid to the methodology of these pre-clinical reports when transferring novel graft coatings into clinical practice. Variables used in pre-clinical reports (bacterial strain, duration of activity coating) do not correspond well to current clinical studies. Based on the results of this review, a proposal for a complete and comprehensive set up for pre-clinical invivo testing of anti-infectious properties of vascular graft coatings was defined.
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Affiliation(s)
- Hozan Mufty
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium.
| | - Jef Van Den Eynde
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium
| | - Bart Meuris
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium
| | | | - Eric Van Wijngaerden
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Hans P Steenackers
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Inge Fourneau
- Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium
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Furdella KJ, Higuchi S, Behrangzade A, Kim K, Wagner WR, Vande Geest JP. In-vivo assessment of a tissue engineered vascular graft computationally optimized for target vessel compliance. Acta Biomater 2021; 123:298-311. [PMID: 33482362 DOI: 10.1016/j.actbio.2020.12.058] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 11/24/2022]
Abstract
Tissue engineered vascular grafts (TEVGs) have the ability to be tuned to match a target vessel's compliance, diameter, wall thickness, and thereby prevent compliance mismatch. In this work, TEVG compliance was manipulated by computationally tuning its layered composition or by manipulating a crosslinking agent (genipin). In particular, these three acelluluar TEVGs were compared: a compliance matched graft (CMgel - high gelatin content); a hypocompliant PCL graft (HYPOpcl - high polycaprolactone content); and a hypocompliant genipin graft (HYPOgen - equivalent composition as CMgel but hypocompliant via increased genipin crosslinking). All constructs were implanted interpositionally into the abdominal aorta of 21 Sprague Dawley rats (n=7, males=11, females=10) for 28 days, imaged in-vivo using ultrasound, explanted, and assessed for remodeling using immunofluorescence and two photon excitation fluorescence imaging. Compliance matched grafts remained compliance-matched in-vivo compared to the hypocompliant grafts through 4 weeks (p<0.05). Construct degradation and cellular infiltration was increased in the CMgel and HYPOgen TEVGs. Contractile smooth muscle cell markers in the proximal anastomosis of the graft were increased in the CMgel group compared to the HYPOpcl (p=0.007) and HYPOgen grafts (p=0.04). Both hypocompliant grafts also had an increased pro-inflammatory response (increased ratio of CD163 to CD86 in the mid-axial location) compared to the CMgel group. Our results suggest that compliance matching using a computational optimization approach leads to the improved acute (28 day) remodeling of TEVGs. To the authors' knowledge, this is the first in-vivo rat study investigating TEVGs that have been computationally optimized for target vessel compliance.
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Meng X, Cheng Y, Wang P, Chen K, Chen Z, Liu X, Fu X, Wang K, Liu K, Liu Z, Duan X. Enhanced Hemocompatibility of a Direct Chemical Vapor Deposition-Derived Graphene Film. ACS APPLIED MATERIALS & INTERFACES 2021; 13:4835-4843. [PMID: 33474941 DOI: 10.1021/acsami.0c19790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A wide range of biomedical devices are being used to treat cardiovascular diseases, and thus they routinely come into contact with blood. Insufficient hemocompatibility has been found to impair the functionality and safety of these devices through the activation of blood coagulation and the immune system. Numerous attempts have been made to develop surface modification approaches of the cardiovascular devices to improve their hemocompatibility. However, there are still no ideal "blood-friendly" coating materials, which possess the desired hemocompatibility, tissue compatibility, and mechanical properties. As a novel multifunctional material, graphene has been proposed for a wide range of biomedical applications. The chemical inertness, atomic smoothness, and high durability make graphene an ideal candidate as a surface coating material for implantable devices. Here, we evaluated the hemocompatibility of a graphene film prepared on quartz glasses (Gra-glasses) from a direct chemical vapor deposition process. We found that the graphene coating, which is free of transfer-mediating polymer contamination, significantly suppressed platelet adhesion and activation, prolonged coagulation time, and reduced ex vivo thrombosis formation. We attribute the excellent antithrombogenic properties of the Gra-glasses to the low surface roughness, low surface energy (especially the low polar component of the surface energy), and the negative surface charge of the graphene film. Given these excellent hemocompatible properties, along with its chemical inertness, high durability, and molecular impermeability, a graphene film holds great promise as an antithrombogenic coating for next-generation cardiovascular devices.
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Affiliation(s)
- Xuejuan Meng
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Yi Cheng
- College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, China
| | - Puxin Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Ke Chen
- College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, China
| | - Zhaolong Chen
- College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, China
| | - Xiaojun Liu
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Xuefeng Fu
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Kun Wang
- College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, China
| | - Kaihui Liu
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
- State Key Laboratory for Mesoscopic Physics, Frontiers Science Center for Nano-optoelectronics, School of Physics, Peking University, Beijing 100871, China
| | - Zhongfan Liu
- College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Xiaojie Duan
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
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Reva VA, Perevedentcev AV, Pochtarnik AA, Khupov MT, Kalinina AA, Samokhvalov IM, Khan MA. Ultrasound-guided versus blind vascular access followed by REBOA on board of a medical helicopter in a hemorrhagic ovine model. Injury 2021; 52:175-181. [PMID: 33004204 DOI: 10.1016/j.injury.2020.09.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study is to evaluate the feasibility of en-route resuscitative endovascular balloon occlusion of the aorta (REBOA) on board of a helicopter. METHODS Six sedated male sheep (weighing 42-54 kg) underwent a controlled hemorrhage until the systolic blood pressure (BP) dropped to <90 mmHg, and were placed into a low capacity Eurocopter AS-350 (France). During the 30-minutes normal flight, every animal underwent blind (left side) and ultrasound-guided (US) (right side) vascular access (VA) to the femoral artery followed by REBOA: the first catheter (Rescue balloon, Japan) - into Zone I, the second one (MIT, Russia) - Zone III. In case of blind VA failure, an alternate US-puncture was attempted. Six experienced flight anesthetists were enrolled into the study. Vascular access and REBOA catheter placement (confirmed by X-Ray later) success rate and timing were recorded. RESULTS Among six blind punctures one was successful, 2/6 - were into the vein, 3/6 - completely failed and switched to US-punctures (making total number of US-punctures nine). Eight out of nine US-punctures were successful. However, correct wire insertion and sheath placement was performed in 1/6 animal in the 'blind' group and only in 6/9 animals in the 'US' group. It took a median of 65 seconds (range 5-260) for US-puncture and a median of 4 minutes to get the sheath in. Among the 9 VAs, there were 2 REBOA failures (1 ruptured balloon [MIT] and 1 mistaken vena cava placement primarily recognized by a sudden drop of BP and later confirmed by X-Ray). Five out of seven balloons were placed in a desired intra-aortic position: 4/5 in Zone I and 1/2 - in Zone III. A median time for a successful REBOA procedure was 5.0 (range 2.5-10.0) minutes (1 min after sheath placement). CONCLUSION Our study demonstrates the potential feasibility of the en-route REBOA which can be performed within 5 minutes. Ultrasound-guidance is critically important to achieve en-route VA.
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Affiliation(s)
- Viktor A Reva
- Department of War Surgery, Kirov Military Medical Academy, 6 Lebedeva Street, Saint-Petersburg 194044, Russian Federation.
| | - Andrey V Perevedentcev
- Russian National Service of Sanitary Aviation, 56 Pilotov Street, Saint-Petersburg 196210, Russian Federation
| | - Alexander A Pochtarnik
- Department of War Surgery, Kirov Military Medical Academy, 6 Lebedeva Street, Saint-Petersburg 194044, Russian Federation
| | - Murat T Khupov
- Russian National Service of Sanitary Aviation, 56 Pilotov Street, Saint-Petersburg 196210, Russian Federation
| | - Angelina A Kalinina
- Russian National Service of Sanitary Aviation, 56 Pilotov Street, Saint-Petersburg 196210, Russian Federation
| | - Igor M Samokhvalov
- Department of War Surgery, Kirov Military Medical Academy, 6 Lebedeva Street, Saint-Petersburg 194044, Russian Federation
| | - Mansoor A Khan
- Digestive Diseases Department, Brighton and Sussex University Hospitals, Barry Building, Eastern Rd, Brighton BN2 5BE, United Kingdom
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Rocha FA, Ribas LM, Sassaki-Neto PI, DE-Luccia N. Experimental comparative study of arterial implants made of silicone reinforced with polyester fabric and expanded polytetrafluoroethylene (PTFE) in rabbits aorta. Rev Col Bras Cir 2021; 48:e20202587. [PMID: 33533824 PMCID: PMC10683427 DOI: 10.1590/0100-6991e-20202587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/18/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES the aim of this study was to compare the outcomes of a new silicone vascular prostheses with PTFE vascular prostheses, on a rabbit experimental model. METHODS forty rabbits underwent infra-renal aorta replacement with 4 mm diameter prostheses, twenty animals with PDMS and twenty animals with PTFE (control group). Retrograde aortic angiography was performed to assess patency. Histological graft samples were examined by electron microscopy to evaluate prostheses endothelialization. RESULTS patency rates were 100% for both grafts after 30 days; after 60 days, patency rate for PDMS was 92.3% (±7.4), and 73,8% (±13.1) at 90 days. PTFE grafts had patency rates of 87.5% (±11.7) at 60 and 90 days. No statistically significant difference was found in between groups for patency rates (p=0.62). Postoperative complications (death, paraplegia) rates (p=0.526) and aortic clamping times (p=0.299) were comparable in both groups. No statistically significant difference for stenosis was found on angiographical analysis between groups (p=0.650). Electron microscopy revealed limited anastomotic endothelial ingrowth in both prostheses. CONCLUSION in this experimental model, PDMS and PTFE vascular prostheses had comparable outcomes and PDMS prosthesis could be used as a vascular graft.
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Affiliation(s)
- Fernanda Appolonio Rocha
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
- - Universidade Federal de Pernambuco - UFPE, Departamento de Cirurgia - CCM - Recife - PE - Brasil
| | - Laila Massad Ribas
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
| | - Paulo Isao Sassaki-Neto
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
| | - Nelson DE-Luccia
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
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Torres Y, Gluais M, Da Silva N, Rey S, Grémare A, Magnan L, Kawecki F, L’Heureux N. Cell-assembled extracellular matrix (CAM) sheet production: Translation from using human to large animal cells. J Tissue Eng 2021; 12:2041731420978327. [PMID: 33633827 PMCID: PMC7887678 DOI: 10.1177/2041731420978327] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
We have created entirely biological tissue-engineered vascular grafts (TEVGs) using sheets of cell-assembled extracellular matrix (CAM) produced by human fibroblasts in vitro. A large animal TEVG would allow long-term pre-clinical studies in a clinically relevant setting (graft size and allogeneic setting). Therefore, canine, porcine, ovine, and human skin fibroblasts were compared for their ability to form CAM sheets. Serum sourcing greatly influenced CAM production in a species-dependent manner. Ovine cells produced the most homogenous and strongest animal CAM sheets but remained ≈3-fold weaker than human sheets despite variations of serum, ascorbate, insulin, or growth factor supplementations. Key differences in cell growth dynamics, tissue development, and tissue architecture and composition were observed between human and ovine. This study demonstrates critical species-to-species differences in fibroblast behavior and how they pose a challenge when attempting to substitute animal cells for human cells during the development of tissue-engineered constructs that require long-term cultures.
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Affiliation(s)
- Yoann Torres
- University of Bordeaux, INSERM, BIOTIS, Bordeaux, France
| | - Maude Gluais
- University of Bordeaux, INSERM, BIOTIS, Bordeaux, France
| | | | - Sylvie Rey
- University of Bordeaux, INSERM, BIOTIS, Bordeaux, France
| | - Agathe Grémare
- University of Bordeaux, INSERM, BIOTIS, Bordeaux, France
- CHU Bordeaux, Services d’Odontologie et de Santé Buccale, Bordeaux, France
| | - Laure Magnan
- University of Bordeaux, INSERM, BIOTIS, Bordeaux, France
| | - Fabien Kawecki
- University of Bordeaux, INSERM, BIOTIS, Bordeaux, France
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Cellular remodeling of fibrotic conduit as vascular graft. Biomaterials 2020; 268:120565. [PMID: 33310678 DOI: 10.1016/j.biomaterials.2020.120565] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 11/12/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023]
Abstract
The replacement of small-diameter arteries remains an unmet clinical need. Here we investigated the cellular remodeling of fibrotic conduits as vascular grafts. The formation of fibrotic conduit around subcutaneously implanted mandrels involved not only fibroblasts but also the trans-differentiation of inflammatory cells such as macrophages into fibroblastic cells, as shown by genetic lineage tracing. When fibrotic conduits were implanted as vascular grafts, the patency was low, and many fibrotic cells were found in neointima. Decellularization and anti-thrombogenic coating of fibrotic conduits produced highly patent autografts that remodeled into neoarteries, offering an effective approach to obtain autografts for clinical therapy. While autografts recruited mostly anti-inflammatory macrophages for constructive remodeling, allogenic DFCs had more T cells and pro-inflammatory macrophages and lower patency. Endothelial progenitors and endothelial migration were observed during endothelialization. Cell infiltration into DFCs was more efficient than decellularized arteries, and infiltrated cells remodeled the matrix and differentiated into smooth muscle cells (SMCs). This work provides insight into the remodeling of fibrotic conduits, autologous DFCs and allogenic DFCs, and will have broad impact on using fibrotic matrix for regenerative engineering.
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Karaagac E, Besir Y, Kurus M, Gokalp O, Iscan S, Gokkurt Y, Kandemir C, Topal FE, Keselik E, Eygi B, Gurbuz A. The effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on neointimal hyperplasia in rabbit carotid artery anastomosis. J Biomater Appl 2020; 36:152-164. [PMID: 33050834 DOI: 10.1177/0885328220964913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Since the systemic drugs have been used to reduce the hyperplasic response in the tunica intima, the periadventitial local drug applications to the vascular wall have gained more popularity. In this study, we investigated the effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on neointimal hyperplasia in rabbit carotid artery anastomosis to explore the effects of these two different agents. METHODS 21 New Zealand male rabbits were randomly divided into three groups. The carotid artery transection and anastomosis was performed onthe control group. The bovine serum albumin-glutaraldehyde and the polyethylene glycol polymer were applied locally on the other two groups seperatley after transection and anastomosis of the carotid arteries. At the end of 28-day follow-up, the histological and the immunohistochemical results related to neointimal hyperplasia were compared. RESULTS The glue residues were detected in the BSA-glutaraldehyde group, but in the PEG polymer group there was no glue residue. The intima thickness and the intima/media thickness ratio in the control group was significantly higher (p<0.05) than the other groups. These values did not differ significantly between the BSA-glutaraldehyde group and the PEG polymer group (p>0.05). The lumen diameter and the area in the control group were significantly higher (p < 0.05) than the BSA-glutaraldehyde group. These values between the control group and the PEG polymer group did not differ significantly (p>0.05). aSMA-positive staining score in the Control group was found to be significantly lower (p < 0.05) than the BSA-glutaraldehyde and PEG polymer group and the VEGF-positive staining score in the control group was found to be significantly higher (p < 0.05) than the BSA-glutaraldehyde and the PEG polymer group. CONCLUSIONS Although the both agents have positive results on neointimal hyperplasia, it would be favorable to use polyethylene glycol polymer, since it does not seem to affect the lumen area and the lumen diameter of the vessel.
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Affiliation(s)
- Erturk Karaagac
- Department of Cardiovascular Surgery, Muş State Hospital, Muş, Turkey
| | - Yuksel Besir
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Meltem Kurus
- Department of Histology and Embryology, Faculty of Medicine, Izmir KatipÇelebi University, Izmir, Turkey
| | - Orhan Gokalp
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Sahin Iscan
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Yasar Gokkurt
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Cagri Kandemir
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Erdi Keselik
- Department of Histology and Embryology, Faculty of Medicine, Izmir KatipÇelebi University, Izmir, Turkey
| | - Bortecin Eygi
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Ali Gurbuz
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
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Simard T, Motazedian P, Majeed K, Sarathy K, Jung RG, Feder J, Ramirez FD, Di Santo P, Marbach J, Dhaliwal S, Short S, Labinaz A, Schultz C, Russo JJ, So D, Chong AY, Le May M, Hibbert B. Contrast-free optical coherence tomography:Systematic evaluation of non-contrast media for intravascular assessment. PLoS One 2020; 15:e0237588. [PMID: 32817672 PMCID: PMC7446899 DOI: 10.1371/journal.pone.0237588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background Coronary revascularization using imaging guidance is rapidly becoming the standard of care. Intravascular optical coherence tomography uses near-infrared light to obtain high resolution intravascular images. Standard optical coherence tomography imaging technique employs iodinated contrast dye to achieve the required blood clearance during acquisition. We sought to systematically evaluate the technical performance of saline as an alternative to iodinated contrast for intravascular optical coherence tomography assessment. Methods and results We performed bench top optical coherence tomography analysis on nylon tubing with sequential contrast/saline dilutions to empirically derive adjustment coefficients. We then applied these coefficients in vivo in an established rabbit abdominal stenting model with both saline and contrast optical coherence tomography imaging. In this model, we assessed the impact of saline on both quantitative and qualitative vessel assessment. Nylon tubing assessment demonstrated a linear relationship between saline and contrast for both area and diameter. We then derived adjustment coefficients, allowing for accurate calculation of area and diameter when converting saline into both contrast and reference dimensions. In vivo studies confirmed reduced area with saline versus contrast [7.43 (5.67–8.36) mm2 versus 8.2 (6.34–9.39) mm2, p = 0.001] and diameter [3.08 mm versus 3.23 mm, p = 0.001]. Following correction, a strong relationship was achieved in vivo between saline and contrast in both area and diameter without compromising image quality, artefact, or strut assessment. Conclusion Saline generates reduced dimensions compared to contrast during intravascular optical coherence tomography imaging. The relationship across physiologic coronary diameters is linear and can be corrected with high fidelity. Saline does not adversely impact image quality, artefact, or strut assessment.
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Affiliation(s)
- Trevor Simard
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Pouya Motazedian
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kamran Majeed
- Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Kiran Sarathy
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Richard G. Jung
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Joshua Feder
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - F. Daniel Ramirez
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Bordeaux-Pessac, France
- L’Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux-Pessac, France
| | - Pietro Di Santo
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jeffrey Marbach
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Shan Dhaliwal
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Spencer Short
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Alisha Labinaz
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Carl Schultz
- Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Juan J. Russo
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Derek So
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Aun-Yeong Chong
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Michel Le May
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Benjamin Hibbert
- CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
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Jeong Y, Yao Y, Yim EKF. Current understanding of intimal hyperplasia and effect of compliance in synthetic small diameter vascular grafts. Biomater Sci 2020; 8:4383-4395. [PMID: 32643723 PMCID: PMC7452756 DOI: 10.1039/d0bm00226g] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Despite much effort, synthetic small diameter vascular grafts still face limited success due to vascular wall thickening known as intimal hyperplasia (IH). Compliance mismatch between graft and native vessels has been proposed to be one of a key mechanical factors of synthetic vascular grafts that could contribute to the formation of IH. While many methods have been developed to determine compliance both in vivo and in vitro, the effects of compliance mismatch still remain uncertain. This review aims to explain the biomechanical factors that are responsible for the formation and development of IH and their relationship with compliance mismatch. Furthermore, this review will address the current methods used to measure compliance both in vitro and in vivo. Lastly, current limitations in understanding the connection between the compliance of vascular grafts and the role it plays in the development and progression of IH will be discussed.
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Affiliation(s)
- YeJin Jeong
- Department of Chemical engineering, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
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43
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Ryder M, Gunther RA, Nishikawa RA, Stranz M, Meyer BM, Spangler TA, Parker AE, Sylvia C. Investigation of the role of infusate properties related to midline catheter failure in an ovine model. Am J Health Syst Pharm 2020; 77:1336-1346. [PMID: 32706023 PMCID: PMC7411746 DOI: 10.1093/ajhp/zxaa175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Infusate osmolarity, pH, and cytotoxicity were investigated as risk factors for midline catheter failure. METHODS An experimental, randomized, controlled, blinded trial was conducted using an ovine model. Two 10-cm, 18-gauge single-lumen midline catheters were inserted into the cephalic veins of sheep. The animals were divided into 6 study arms and were administered solutions of vancomycin 4 mg/mL (a low-cytotoxicity infusate) or 10 mg/mL (a high-cytotoxicity infusate), doxycycline 1 mg/mL (an acidic infusate), or acyclovir 3.5 mg/mL (an alkaline infusate) and 0.9% sodium chloride injection; or 1 of 2 premixed Clinimix (amino acids in dextrose; Baxter International) products with respective osmolarities of 675 mOsm/L (a low-osmolarity infusate) and 930 mOsm/L (a mid-osmolarity infusate). Contralateral legs were infused with 0.9% sodium chloride injection for control purposes. Catheter failure was evaluated by assessment of adverse clinical symptoms (swelling, pain, leakage, and occlusion). A quantitative vessel injury score (VIS) was calculated by grading 4 histopathological features: inflammation, mural thrombus, necrosis, and perivascular reaction. RESULTS Among 20 sheep included in the study, the overall catheter failure rate was 95% for test catheters (median time to failure, 7.5 days; range, 3-14 days), while 60% of the control catheters failed before or concurrently (median time to failure, 7 days; range, 4.5-14 days). Four of the 6 study arms (all but the Clinimix 675-mOsm/L and acyclovir 3.5-mg/mL arms) demonstrated an increase in mean VIS of ≥77% in test vs control legs (P ≤ 0.034). Both pain and swelling occurred at higher rates in test vs control legs: 65% vs 10% and 70% vs 50%, respectively. The mean difference in rates of occlusive pericatheter mural thrombus between the test and control arms was statistically significant for the vancomycin 10-mg/mL (P = 0.0476), Clinimix 930-mOsm/L (P = 0.0406), and doxycycline 1-mg/mL (P = 0.032) arms. CONCLUSION Administration of infusates of varied pH, osmolarity, and cytotoxicity via midline catheter resulted in severe vascular injury and premature catheter failure; therefore, the tested infusates should not be infused via midline catheters.
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Affiliation(s)
| | | | | | | | - Britt M Meyer
- Duke University Hospital, Durham, NC
- East Carolina University School of Nursing, Greenville, NC
| | - Taylor A Spangler
- VDx Veterinary Diagnostics and Preclinical Research Services, Davis, CA
| | - Albert E Parker
- Center for Biofilm Engineering, Department of Mathematical Sciences, Montana State University, Bozeman, MT
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44
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Yao Y, Zaw AM, Anderson DEJ, Hinds MT, Yim EKF. Fucoidan functionalization on poly(vinyl alcohol) hydrogels for improved endothelialization and hemocompatibility. Biomaterials 2020; 249:120011. [PMID: 32304872 PMCID: PMC7748769 DOI: 10.1016/j.biomaterials.2020.120011] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/10/2020] [Accepted: 03/27/2020] [Indexed: 12/31/2022]
Abstract
The performance of clinical synthetic small diameter vascular grafts remains disappointing due to the fast occlusion caused by thrombosis and intimal hyperplasia formation. Poly(vinyl alcohol) (PVA) hydrogels have tunable mechanical properties and a low thrombogenic surface, which suggests its potential value as a small diameter vascular graft material. However, PVA does not support cell adhesion and thus requires surface modification to encourage endothelialization. This study presents a modification of PVA with fucoidan. Fucoidan is a sulfated polysaccharide with anticoagulant and antithrombotic properties, which was shown to potentially increase endothelial cell adhesion and proliferation. By mixing fucoidan with PVA and co-crosslinked by sodium trimetaphosphate (STMP), the modification was achieved without sacrificing mechanical properties. Endothelial cell adhesion and monolayer function were significantly enhanced by the fucoidan modification. In vitro and ex-vivo studies showed low platelet adhesion and activation and decreased thrombin generation with fucoidan modified PVA. The modification proved to be compatible with gamma sterilization. In vivo evaluation of fucoidan modified PVA grafts in rabbits exhibited increased patency rate, endothelialization, and reduced intimal hyperplasia formation. The fucoidan modification presented here benefited the development of PVA vascular grafts and can be adapted to other blood contacting surfaces.
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Affiliation(s)
- Yuan Yao
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Aung Moe Zaw
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Deirdre E J Anderson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Monica T Hinds
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Evelyn K F Yim
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Waterloo Institute for Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Biotechnology and Bioengineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
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45
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Heinsar S, Rozencwajg S, Suen J, Bassi GL, Malfertheiner M, Vercaemst L, Broman LM, Schmidt M, Combes A, Rätsep I, Fraser JF, Millar JE. Heart failure supported by veno-arterial extracorporeal membrane oxygenation (ECMO): a systematic review of pre-clinical models. Intensive Care Med Exp 2020; 8:16. [PMID: 32451698 PMCID: PMC7248156 DOI: 10.1186/s40635-020-00303-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/11/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used to treat patients with refractory severe heart failure. Large animal models are developed to help understand physiology and build translational research projects. In order to better understand those experimental models, we conducted a systematic literature review of animal models combining heart failure and VA-ECMO. STUDIES SELECTION A systematic review was performed using Medline via PubMed, EMBASE, and Web of Science, from January 1996 to January 2019. Animal models combining experimental acute heart failure and ECMO were included. Clinical studies, abstracts, and studies not employing VA-ECMO were excluded. DATA EXTRACTION Following variables were extracted, relating to four key features: (1) study design, (2) animals and their peri-experimental care, (3) heart failure models and characteristics, and (4) ECMO characteristics and management. RESULTS Nineteen models of heart failure and VA-ECMO were included in this review. All were performed in large animals, the majority (n = 13) in pigs. Acute myocardial infarction (n = 11) with left anterior descending coronary ligation (n = 9) was the commonest mean of inducing heart failure. Most models employed peripheral VA-ECMO (n = 14) with limited reporting. CONCLUSION Among models that combined severe heart failure and VA-ECMO, there is a large heterogeneity in both design and reporting, as well as methods employed for heart failure. There is a need for standardization of reporting and minimum dataset to ensure translational research achieve high-quality standards.
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Affiliation(s)
- Silver Heinsar
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia.,Second Department of Intensive Care, North Estonia Medical Centre, Talinn, Estonia
| | - Sacha Rozencwajg
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia. .,Sorbonne Université, INSERM, UMRS-1166, ICAN Institute of Cardiometabolism and Nutrition, Medical ICU, Pitié-Salpêtrière University Hospital, 47, bd de l'Hôpital, 75651, Paris Cedex 13, France.
| | - Jacky Suen
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia.
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia
| | - Maximilian Malfertheiner
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia.,Department of Internal Medicine II, Cardiology and Pneumology, University Medical Center Regensburg, Regensburg, Germany
| | - Leen Vercaemst
- Department of Perfusion, University Hospital Gasthuisberg, Louven, Belgium
| | - Lars Mikael Broman
- ECMO Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Matthieu Schmidt
- Second Department of Intensive Care, North Estonia Medical Centre, Talinn, Estonia
| | - Alain Combes
- Second Department of Intensive Care, North Estonia Medical Centre, Talinn, Estonia
| | - Indrek Rätsep
- Sorbonne Université, INSERM, UMRS-1166, ICAN Institute of Cardiometabolism and Nutrition, Medical ICU, Pitié-Salpêtrière University Hospital, 47, bd de l'Hôpital, 75651, Paris Cedex 13, France
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia
| | - Jonathan E Millar
- Critical Care Research Group, The Prince Charles Hospital, University of Queensland, Chermside, Brisbane, Australia.,Wellcome-Wolfson Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
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46
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Elliott W, Guo D, Veldtman G, Tan W. Effect of Viscoelasticity on Arterial-Like Pulsatile Flow Dynamics and Energy. J Biomech Eng 2020; 142:041001. [PMID: 31523750 PMCID: PMC7104782 DOI: 10.1115/1.4044877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 08/16/2019] [Indexed: 11/08/2022]
Abstract
Time-dependent arterial wall property is an important but difficult topic in vascular mechanics. Hysteresis, which appears during the measurement of arterial pressure-diameter relationship through a cardiac cycle, has been used to indicate time-dependent mechanics of arteries. However, the cause-effect relationship between viscoelastic (VE) properties of the arterial wall and hemodynamics, particularly the viscous contribution to hemodynamics, remains challenging. Herein, we show direct comparisons between elastic (E) (loss/storage < 0.1) and highly viscoelastic (loss/storage > 0.45) conduit structures with arterial-like compliance, in terms of their capability of altering pulsatile flow, wall shear, and energy level. Conduits were made from varying ratio of vinyl- and methyl-terminated poly(dimethylsiloxane) and were fit in a mimetic circulatory system measuring volumetric flow, pressure, and strain. Results indicated that when compared to elastic conduits, viscoelastic conduits attenuated lumen distension waveforms, producing an average of 11% greater cross-sectional area throughout a mimetic cardiac cycle. In response to such changes in lumen diameter strain, pressure and volumetric flow waves in viscoelastic conduits decreased by 3.9% and 6%, respectively, in the peak-to-peak amplitude. Importantly, the pulsatile waveforms for both diameter strain and volumetric flow demonstrated greater temporal alignment in viscoelastic conduits due to pulsation attenuation, resulting in 25% decrease in the oscillation of wall shear stress (WSS). We hope these findings may be used to further examine time-dependent arterial properties in disease prognosis and progression, as well as their use in vascular graft design.
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Affiliation(s)
- Winston Elliott
- Department of Mechanical Engineering, University of Colorado at
Boulder, 1111 Engineering Drive, ECME 114,
Boulder, CO 80309
| | - Dongjie Guo
- Department of Mechanical Engineering, University of Colorado at
Boulder, 1111 Engineering Drive, ECME 114,
Boulder, CO 80309; State Laboratory
of Surface and Interface, Zhengzhou University of Light
Industry, Zhengzhou 450002
China
| | - Gruschen Veldtman
- Department of Pediatrics, Cincinnati Children's
Hospital, University of Cincinnati, 3333 Burnet Ave,
Cincinnati, OH 45229
| | - Wei Tan
- Department of Mechanical Engineering, University of Colorado at
Boulder, 1111 Engineering Drive, ECME 114,
Boulder, CO 80309
e-mail:
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Cordelle J, Mantero S. Insight on the endothelialization of small silk-based tissue-engineered vascular grafts. Int J Artif Organs 2020; 43:631-644. [DOI: 10.1177/0391398820906547] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Along with an increased incidence of cardiovascular diseases, there is a strong need for small-diameter vascular grafts. Silk has been investigated as a biomaterial to develop such grafts thanks to different processing options. Endothelialization was shown to be extremely important to ensure graft patency and there is ongoing research on the development and behavior of endothelial cells on vascular tissue-engineered scaffolds. This article reviews the endothelialization of silk-based scaffolds processed throughout the years as silk non-woven nets, films, gel spun, electrospun, or woven scaffolds. Encouraging results were reported with these scaffolds both in vitro and in vivo when implanted in small- to middle-sized animals. The use of coatings and heparin or sulfur to enhance, respectively, cell adhesion and scaffold hemocompatibility is further presented. Bioreactors also showed their interest to improve cell adhesion and thus promoting in vitro pre-endothelialization of grafts even though they are still not systematically used. Finally, the importance of the animal models used to study the right mechanism of endothelialization is discussed.
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Affiliation(s)
| | - Sara Mantero
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta,” Politecnico di Milano, Milan, Italy
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48
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Boorman S, Douglas H, Driessen B, Gillespie MJ, Schaer TP. Fatal Ovarian Hemorrhage Associated With Anticoagulation Therapy in a Yucatan Mini-Pig Following Venous Stent Implantation. Front Vet Sci 2020; 7:18. [PMID: 32083102 PMCID: PMC7002391 DOI: 10.3389/fvets.2020.00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 01/10/2020] [Indexed: 01/10/2023] Open
Abstract
Swine models are commonly utilized in endovascular research for development of intravascular interventions and medical device development. As part of a pilot study for a venous vascular stent device, a 5-year-old female Yucatan mini-pig underwent bilateral external iliac vein stent placement under general anesthesia. To reduce thrombotic complications by reduction of thrombus formation on wires, sheaths, and catheters, the pig was heparinized with a total of 300 IU/kg of heparin, establishing an activated clotting time (ACT) of 436 s. The ACT had returned to below 200 s by the end of the procedure. To prevent postoperative thrombosis, the pig received an anticoagulation therapy protocol consisting of enoxaparin, clopidogrel, and aspirin. There were no complications during the immediate postoperative period. However, the pig died 4 days after surgery. Necropsy established the cause of death as abdominal exsanguination due to severe, acute, intra-ovarian hemorrhage, most likely related to ovulation. Life-threatening ovarian hemorrhage is occasionally seen in women with congenital or acquired bleeding disorders; to our knowledge this is the first report of fatal ovarian hemorrhage in an animal enrolled in a pre-clinical research trial.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, United States
| | - Hope Douglas
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Bernd Driessen
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Matthew J Gillespie
- Department of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Thomas P Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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49
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Animal Surgery and Care of Animals. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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50
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Alessandrino A, Chiarini A, Biagiotti M, Dal Prà I, Bassani GA, Vincoli V, Settembrini P, Pierimarchi P, Freddi G, Armato U. Three-Layered Silk Fibroin Tubular Scaffold for the Repair and Regeneration of Small Caliber Blood Vessels: From Design to in vivo Pilot Tests. Front Bioeng Biotechnol 2019; 7:356. [PMID: 31850325 PMCID: PMC6895545 DOI: 10.3389/fbioe.2019.00356] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/08/2019] [Indexed: 01/12/2023] Open
Abstract
Silk fibroin (SF) is an eligible biomaterial for the development of small caliber vascular grafts for substitution, repair, and regeneration of blood vessels. This study presents the properties of a newly designed multi-layered SF tubular scaffold for vascular grafting (SilkGraf). The wall architecture consists of two electrospun layers (inner and outer) and an intermediate textile layer. The latter was designed to confer high mechanical performance and resistance on the device, while electrospun layers allow enhancing its biomimicry properties and host's tissues integration. In vitro cell interaction studies performed with adult Human Coronary Artery Endothelial Cells (HCAECs), Human Aortic Smooth Muscle Cells (HASMCs), and Human Aortic Adventitial Fibroblasts (HAAFs) demonstrated that the electrospun layers favor cell adhesion, survival, and growth. Once cultured in vitro on the SF scaffold the three cell types showed an active metabolism (consumption of glucose and glutamine, release of lactate), and proliferation for up to 20 days. HAAF cells grown on SF showed a significantly lower synthesis of type I procollagen than on polystyrene, meaning a lower fibrotic effect of the SF substrate. The cytokine and chemokine expression patterns were investigated to evaluate the cells' proliferative and pro-inflammatory attitude. Interestingly, no significant amounts of truly pro-inflammatory cytokines were secreted by any of the three cell types which exhibited a clearly proliferative profile. Good hemocompatibility was observed by complement activation, hemolysis, and hematology assays. Finally, the results of an in vivo preliminary pilot trial on minipig and sheep to assess the functional behavior of implanted SF-based vascular graft identified the sheep as the more apt animal model for next medium-to-long term preclinical trials.
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Affiliation(s)
| | - Anna Chiarini
- Human Histology & Embryology Section, Department of Surgery, Dentistry, Pediatrics & Gynecology, University of Verona Medical School, Verona, Italy
| | | | - Ilaria Dal Prà
- Human Histology & Embryology Section, Department of Surgery, Dentistry, Pediatrics & Gynecology, University of Verona Medical School, Verona, Italy
| | | | | | | | | | | | - Ubaldo Armato
- Human Histology & Embryology Section, Department of Surgery, Dentistry, Pediatrics & Gynecology, University of Verona Medical School, Verona, Italy
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