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Kingsmore D, Jackson A, Stevenson K. A critical review of surgical strategies to minimise venous stenosis in arteriovenous grafts. J Vasc Access 2021; 24:11297298211060944. [PMID: 34847754 DOI: 10.1177/11297298211060944] [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] [Indexed: 11/16/2022] Open
Abstract
It is inevitable that complications arising from surgical procedures are ascribed to surgical technique, and this applies to venous stenosis (VS) in arteriovenous grafts. However, despite a wide range of cellular studies, computer modelling, observational series and clinical trials, there remains uncertainty on whether surgical technique contributes to VS. This article reviews evidence from basic science, fluid dynamics and clinical data to try and rationalise the main surgical options to modify the occurrence of venous stenosis. There is sufficient data from diverse sources to make recommendations on clinical practice (size of target vein, shape of anastomosis, angle of approach, distance from venous needling, trauma to the target vein) whilst at the same time this emphasises the need to carefully report the practical aspects of surgical technique in future clinical trials.
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Affiliation(s)
- David Kingsmore
- Department of Vascular Surgery, Queen Elizabeth University Hospital Trust, Glasgow, UK
- Department of Renal Transplantation, Queen Elizabeth University Hospital Trust, Glasgow, UK
| | - Andrew Jackson
- Department of Renal Transplantation, Queen Elizabeth University Hospital Trust, Glasgow, UK
| | - Karen Stevenson
- Department of Renal Transplantation, Queen Elizabeth University Hospital Trust, Glasgow, UK
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2
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The Effect of Geometric Graft Modification on Arteriovenous Graft Patency in Haemodialysis Patients: A Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg 2020; 60:568-577. [PMID: 32807670 DOI: 10.1016/j.ejvs.2020.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/30/2020] [Accepted: 06/16/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Arteriovenous grafts (AVGs) are the second best option for haemodialysis access when native arteriovenous fistulae placement is not possible, because they have a lower patency owing to neointimal hyperplasia at the venous anastomosis. This review aimed to evaluate the effect of geometric graft modification to the graft-vein interface on AVG patency. DATA SOURCES The MEDLINE and Embase (OvidSP) databases were systematically searched for relevant studies analysing the effect of geometrically modified AVGs on graft patency and stenosis formation (last search July 2019). REVIEW METHODS Data regarding AVG type, patency, and graft outlet stenosis was extracted for further evaluation. Data were pooled in a random effects model to estimate the relative risk of graft occlusion within one year. Follow up, number of patients, and relevant patient characteristics were extracted for the quality assessment of the included studies using Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool. The quality of the evidence was determined according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. RESULTS Search strategies produced 2772 hits, of which eight articles met predetermined inclusion criteria. Overall, the included articles had low to moderate risk of bias. In total, 414 expanded polytetrafluoroethylene AVGs (232 geometrically modified and 182 standard) were analysed, comprising two modified AVG types: a prosthetic cuff design (Venaflo®) and grafts with a Tyrell vein patch. Overall, modified grafts did not show a statistically significantly higher one year primary (relative risk [RR] 0.86, 95% confidence interval [CI] 95% 0.64-1.16; GRADE: "low to very low") or secondary patency (RR 0.57, 95% CI 0.32-1.02; GRADE: "low to very low") when compared with standard AVGs. Analysis of prosthetic cuffed grafts (112 patients) separately demonstrated a statistically significantly higher one year primary (RR 0.75, 95% CI 0.61-0.91) and one year secondary patency (RR 0.47, 95% CI 0.30-0.75) compared with standard grafts (92 patients). The results on stenosis formation were inconclusive and inadmissible to quantitative analyses. CONCLUSION The meta-analysis showed that a prosthetic cuff design significantly improves AVG patency, while a venous cuff does not. Although the heterogeneity and low number of available studies limit the strength of the results, this review shows the potential of grafts with geometric modification to the graft-vein anastomosis and should stimulate further clinical and fundamental research on improving graft geometry to improve graft patency.
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3
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Shin YC, Lee JB, Kim DH, Kim T, Alexander G, Shin YM, Park JY, Baek S, Yoon JK, Lee YJ, Seon GM, Lee MH, Kang ML, Jang WS, Park JC, Jun HW, Kim Y, Sung HJ. Development of a Shape-Memory Tube to Prevent Vascular Stenosis. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2019; 31:e1904476. [PMID: 31454108 DOI: 10.1002/adma.201904476] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/09/2019] [Indexed: 06/10/2023]
Abstract
Inserting a graft into vessels with different diameters frequently causes severe damage to the host vessels. Poor flow patency is an unresolved issue in grafts, particularly those with diameters less than 6 mm, because of vessel occlusion caused by disturbed blood flow following fast clotting. Herein, successful patency in the deployment of an ≈2 mm diameter graft into a porcine vessel is reported. A new library of property-tunable shape-memory polymers that prevent vessel damage by expanding the graft diameter circumferentially upon implantation is presented. The polymers undergo seven consecutive cycles of strain energy-preserved shape programming. Moreover, the new graft tube, which features a diffuser shape, minimizes disturbed flow formation and prevents thrombosis because its surface is coated with nitric-oxide-releasing peptides. Improved patency in a porcine vessel for 18 d is demonstrated while occlusive vascular remodeling occurs. These insights will help advance vascular graft design.
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Affiliation(s)
- Yong Cheol Shin
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jung Bok Lee
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Dae-Hyun Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Taeyoung Kim
- George W. Woodruff School of Mechanical Engineering, Wallace H. Coulter Department of Biomedical Engineering, Institute for Electronics and Nanotechnology, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | | | - Young Min Shin
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | | | - Sewoom Baek
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jeong-Kee Yoon
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong Jae Lee
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Gyeung Mi Seon
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Mi Hee Lee
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Mi-Lan Kang
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- TMD Lab., Seoul, 03722, Republic of Korea
| | | | - Jong-Chul Park
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ho-Wook Jun
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - YongTae Kim
- George W. Woodruff School of Mechanical Engineering, Wallace H. Coulter Department of Biomedical Engineering, Institute for Electronics and Nanotechnology, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Hak-Joon Sung
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
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4
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Liisberg M, Stenger M, Behr-Rasmussen C, Stubbe J, Lindholt JS. Experimental comparative study of thrombogenicity of two differently luminal heparinized ePTFE vascular prosthetics. Ann Med Surg (Lond) 2018; 35:76-81. [PMID: 30294434 PMCID: PMC6170203 DOI: 10.1016/j.amsu.2018.09.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction ; Heparin bonded grafts have proven to improve patency, at least transiently. Two different heparin bonded expanded polytetrafluoroethylene (ePTFE) grafts produced by different technologies are currently available. This pilot primary goal was to test these commonly used, but differently heparinized ePTFE grafts for differences in primary patency after a 6-months follow-up in a sheep model. Secondly, the aim was to establish a large animal model to enable future translational studies and further graft development. Method ; End-to-side bypass of the common carotid artery was performed bilaterally in sheep. Either a Gore® Propaten heparinized graft or a Jotec® Flowline Bipore heparinized graft was used, both 5 mm in diameter. Following graft implantation, the sheep were kept on pasture for 6 months, with monthly duplex scans to determine patency. At termination, the grafts were duplex scanned a final time, with the animals sedated, and the grafts were removed for heparin activity analysis. Results ; 14 sheep were operated, 11 survived total follow-up time. At final follow-up, 4 patent Gore® grafts, and 6 Jotec® remained. Mean patency time was 106.7 ± 21.9(SD) days and 96.2 ± 25.9(SD) days for Gore® and Jotec®, respectively. Log-rank test showed no significant difference at final follow-up after 6 months. Post mortem heparin analysis showed no significant difference in mean activity. Conclusion ; Based on patency data alone, no significant difference between these grafts were found. In accordance, heparin activity analysis showed no difference between the grafts. The model itself, proved easily implementable, and provides many possibilities for future studies, though some adjustments should be made to improve survival. First direct comparison of heparinized graft. No significant difference in patency or heparin activity concerning the two grafts. Animal model is easily implementable, and expandable to include numerous innovations.
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Affiliation(s)
- Mads Liisberg
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Cardiovascular Centre of Excellence (CAVAC), Denmark.,Elitary Research Centre of Individualised Treatment of Arterial Diseases (CIMA), Odense University Hospital, Denmark
| | - Michael Stenger
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Cardiovascular Centre of Excellence (CAVAC), Denmark.,Elitary Research Centre of Individualised Treatment of Arterial Diseases (CIMA), Odense University Hospital, Denmark
| | | | - Jane Stubbe
- Elitary Research Centre of Individualised Treatment of Arterial Diseases (CIMA), Odense University Hospital, Denmark.,Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Denmark
| | - Jes S Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Cardiovascular Centre of Excellence (CAVAC), Denmark.,Elitary Research Centre of Individualised Treatment of Arterial Diseases (CIMA), Odense University Hospital, Denmark.,Department of Vascular Surgery, Viborg Hospital, Denmark
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5
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Wise SG, Liu H, Kondyurin A, Byrom MJ, Bannon PG, Edwards GA, Weiss AS, Bao S, Bilek MM. Plasma Ion Activated Expanded Polytetrafluoroethylene Vascular Grafts with a Covalently Immobilized Recombinant Human Tropoelastin Coating Reducing Neointimal Hyperplasia. ACS Biomater Sci Eng 2016; 2:1286-1297. [DOI: 10.1021/acsbiomaterials.6b00208] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Steven G. Wise
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, New South Wales 2042, Australia
- Sydney
Medical School, University of Sydney, Edward Ford Building (A27), Fisher
Road, Sydney, New South Wales 2006, Australia
- School
of Molecular Bioscience, University of Sydney, Biochemistry Building (G08), Butlin
Avenue, Sydney, New South
Wales 2006, Australia
| | - Hongjuan Liu
- Department
of Pathology, University of Sydney, Blackburn Building (D06), Blackburn Circuit, Sydney, New South Wales 2006, Australia
| | - Alexey Kondyurin
- School
of Physics (A28), University of Sydney, Physics Road, Sydney, New South Wales 2006, Australia
| | - Michael J. Byrom
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, New South Wales 2042, Australia
- The Baird Institute, Suite 305, 100 Carillon Avenue, Newtown, Sydney, New South Wales 2042, Australia
| | - Paul G. Bannon
- Sydney
Medical School, University of Sydney, Edward Ford Building (A27), Fisher
Road, Sydney, New South Wales 2006, Australia
- The Baird Institute, Suite 305, 100 Carillon Avenue, Newtown, Sydney, New South Wales 2042, Australia
| | - Glenn A. Edwards
- School
of Veterinary Science, University of Melbourne, 757 Swanston Street, Parkville, Victoria 3030, Australia
| | - Anthony S. Weiss
- School
of Molecular Bioscience, University of Sydney, Biochemistry Building (G08), Butlin
Avenue, Sydney, New South
Wales 2006, Australia
- Bosch
Institute, University of Sydney, Anderson Stuart Building (F13), Fisher Road, Sydney, New
South Wales 2006, Australia
- Charles
Perkins Centre (D17), University of Sydney, John Hopkins Drive, Sydney, New South Wales 2006, Australia
| | - Shisan Bao
- Department
of Pathology, University of Sydney, Blackburn Building (D06), Blackburn Circuit, Sydney, New South Wales 2006, Australia
| | - Marcela M. Bilek
- School
of Physics (A28), University of Sydney, Physics Road, Sydney, New South Wales 2006, Australia
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6
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Graft Modification Strategies to Improve Patency of Prosthetic Arteriovenous Grafts for Hemodialysis. J Vasc Access 2016; 17 Suppl 1:S85-90. [DOI: 10.5301/jva.5000526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/20/2022] Open
Abstract
Prosthetic arteriovenous grafts (AVGs) are indicated for vascular access for long-term hemodialysis in patients in whom creation or maintenance of an arteriovenous fistula (AVF) has failed or is contraindicated. AVGs have an inferior long-term patency as compared to AVFs. To ameliorate patency rates of prosthetic AVGs, different strategies have emerged to improve graft materials. This review aims to describe current strategies and future perspectives on graft modification, by graft geometry, drug coatings and graft surface technology, to improve AVG patency.
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7
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Botelho G, Bernardini C, Zannoni A, Ventrella V, Bacci ML, Forni M. Effect of tributyltin on mammalian endothelial cell integrity. Comp Biochem Physiol C Toxicol Pharmacol 2015; 176-177:79-86. [PMID: 26256121 DOI: 10.1016/j.cbpc.2015.07.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/22/2015] [Accepted: 07/29/2015] [Indexed: 12/19/2022]
Abstract
Tributyltin (TBT), is a man-made pollutants, known to accumulate along the food chain, acting as an endocrine disruptor in marine organisms, with toxic and adverse effects in many tissues including vascular system. Based on the absence of specific studies of TBT effects on endothelial cells, we aimed to evaluate the toxicity of TBT on primary culture of porcine aortic endothelial cells (pAECs), pig being an excellent model to study human cardiovascular disease. pAECs were exposed for 24h to TBT (100, 250, 500, 750 and 1000nM) showing a dose dependent decrease in cell viability through both apoptosis and necrosis. Moreover the ability of TBT (100 and 500nM) to influence endothelial gene expression was investigated at 1, 7 and 15h of treatment. Gene expression of tight junction molecules, occludin (OCLN) and tight junction protein-1 (ZO-1) was reduced while monocyte adhesion and adhesion molecules ICAM-1 and VCAM-1 (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1) levels increased significantly at 1h. IL-6 and estrogen receptors 1 and 2 (ESR-1 and ESR-2) mRNAs, after a transient decrease, reached the maximum levels after 15h of exposure. Finally, we demonstrated that TBT altered endothelial functionality greatly increasing monocyte adhesion. These findings indicate that TBT deeply alters endothelial profile, disrupting their structure and interfering with their ability to interact with molecules and other cells.
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Affiliation(s)
- G Botelho
- Department of Veterinary Medical Sciences - DEVET, UNICENTRO - Universidade Estadual do Centro, Oeste do Paraná, Brazil.
| | - C Bernardini
- Department of Veterinary Medical Sciences - DIMEVET, University of Bologna, Ozzano Emilia, Bologna, Italy.
| | - A Zannoni
- Department of Veterinary Medical Sciences - DIMEVET, University of Bologna, Ozzano Emilia, Bologna, Italy.
| | - V Ventrella
- Department of Veterinary Medical Sciences - DIMEVET, University of Bologna, Ozzano Emilia, Bologna, Italy.
| | - M L Bacci
- Department of Veterinary Medical Sciences - DIMEVET, University of Bologna, Ozzano Emilia, Bologna, Italy.
| | - M Forni
- Department of Veterinary Medical Sciences - DIMEVET, University of Bologna, Ozzano Emilia, Bologna, Italy.
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8
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Gessaroli M, Tarantini S, Leone M, Fabbri E, Panzini I. A Comparison of Femorocrural Bypasses Performed with Modified Heparin-Bonded Expanded Polytetrafluorethylene Grafts and Those with Great Saphenous Vein Grafts to Treat Critical Limb Ischemia. Ann Vasc Surg 2015; 29:1255-64. [DOI: 10.1016/j.avsg.2015.03.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
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9
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Zaniboni A, Bernardini C, Bertocchi M, Zannoni A, Bianchi F, Avallone G, Mangano C, Sarli G, Calzà L, Bacci ML, Forni M. In vitro differentiation of porcine aortic vascular precursor cells to endothelial and vascular smooth muscle cells. Am J Physiol Cell Physiol 2015; 309:C320-31. [PMID: 26135800 DOI: 10.1152/ajpcell.00049.2015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/23/2015] [Indexed: 12/29/2022]
Abstract
Recent findings suggest that progenitor and multipotent mesenchymal stromal cells (MSCs) are associated with vascular niches. Cells displaying mesenchymal properties and differentiating to whole components of a functional blood vessel, including endothelial and smooth muscle cells, can be defined as vascular stem cells (VSCs). Recently, we isolated a population of porcine aortic vascular precursor cells (pAVPCs), which have MSC- and pericyte-like properties. The aim of the present work was to investigate whether pAVPCs possess VSC-like properties and assess their differentiation potential toward endothelial and smooth muscle lineages. pAVPCs, maintained in a specific pericyte growth medium, were cultured in high-glucose DMEM + 10% FBS (long-term medium, LTM) or in human endothelial serum-free medium + 5% FBS and 50 ng/ml of hVEGF (endothelial differentiation medium, EDM). After 21 days of culture in LTM, pAVPCs showed an elongated fibroblast-like morphology, and they seem to organize in cord-like structures. qPCR analysis of smooth muscle markers [α-smooth muscle actin (α-SMA), calponin, and smooth muscle myosin (SMM) heavy chain] showed a significant increment of the transcripts, and immunofluorescence analysis confirmed the presence of α-SMA and SMM proteins. After 21 days of culture in EDM, pAVPCs displayed an endothelial cell-like morphology and revealed the upregulation of the expression of endothelial markers (CD31, vascular endothelial-cadherin, von Willebrand factor, and endothelial nitric oxide synthase) showing the CD31-typical pattern. In conclusion, pAVPCs could be defined as a VSC-like population considering that, if they are maintained in a specific pericyte medium, they express MSC markers, and they have, in addition to the classical mesenchymal trilineage differentiation potential, the capacity to differentiate in vitro toward the smooth muscle and the endothelial cell phenotypes.
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Affiliation(s)
- Andrea Zaniboni
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Chiara Bernardini
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy;
| | - Martina Bertocchi
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Augusta Zannoni
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Francesca Bianchi
- Stem Wave Institute for Tissue Healing (SWITH), Gruppo Villa Maria (GVM) Care and Research, Ettore Sansavini Health Science Foundation, Lugo (Ravenna), Italy; National Institute of Biostructures and Biosystems at the Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giancarlo Avallone
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Chiara Mangano
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Giuseppe Sarli
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Laura Calzà
- Department of Pharmacy and Biotechnology (FaBiT), University of Bologna, Bologna, Italy; Health Sciences and Technologies, Interdepartmental Center for Industrial Research (HST-ICIR), University of Bologna, Bologna, Italy
| | - Maria Laura Bacci
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
| | - Monica Forni
- Department of Veterinary Medical Sciences (DIMEVET) University of Bologna, Bologna, Italy
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Cassady AI, Hidzir NM, Grøndahl L. Enhancing expanded poly(tetrafluoroethylene) (ePTFE) for biomaterials applications. J Appl Polym Sci 2014. [DOI: 10.1002/app.40533] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- A. Ian Cassady
- School of Medical Science; Griffith University; Gold Coast Queensland 4222 Australia
| | - Norsyahidah Mohd Hidzir
- School of Chemistry and Molecular Biosciences; University of Queensland; St Lucia Queensland 4072 Australia
- School of Applied Physics; Faculty of Science and Technology, Universiti Kebangsaan Malaysia; UKM Bangi Selangor 43600 Malaysia
| | - Lisbeth Grøndahl
- School of Chemistry and Molecular Biosciences; University of Queensland; St Lucia Queensland 4072 Australia
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11
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Zaniboni A, Bernardini C, Alessandri M, Mangano C, Zannoni A, Bianchi F, Sarli G, Calzà L, Bacci ML, Forni M. Cells derived from porcine aorta tunica media show mesenchymal stromal-like cell properties in in vitro culture. Am J Physiol Cell Physiol 2013; 306:C322-33. [PMID: 24304832 DOI: 10.1152/ajpcell.00112.2013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Several studies have already described the presence of specialized niches of precursor cells in vasculature wall, and it has been shown that these populations share several features with mesenchymal stromal cells (MSCs). Considering the relevance of MSCs in the cardiovascular physiopathology and regenerative medicine, and the usefulness of the pig animal model in this field, we reported a new method for MSC-like cell isolation from pig aorta. Filling the vessel with a collagenase solution for 40 min, all endothelial cells were detached and discarded and then collagenase treatment was repeated for 4 h to digest approximately one-third of the tunica media. The ability of our method to select a population of MSC-like cells from tunica media could be ascribed in part to the elimination of contaminant cells from the intimal layer and in part to the overnight culture in the high antibiotic/antimycotic condition and to the starvation step. Aortic-derived cells show an elongated, spindle shape, fibroblast-like morphology, as reported for MSCs, stain positively for CD44, CD56, CD90, and CD105; stain negatively for CD34 and CD45; and express CD73 mRNA. Moreover, these cells show the classical mesenchymal trilineage differentiation potential. Under our in vitro culture conditions, aortic-derived cells share some phenotypical features with pericytes and are able to take part in the formation of network-like structures if cocultured with human umbilical vein endothelial cells. In conclusion, our work reports a simple and highly suitable method for obtaining large numbers of precursor MSC-like cells derived from the porcine aortic wall.
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Affiliation(s)
- Andrea Zaniboni
- Department of Veterinary Medical Sciences-DIMEVET, University of Bologna, Bologna, Italy
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12
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Zaniboni A, Zannoni A, Bernardini C, De Cecco M, Bombardi C, Seren E, Forni M, Bacci ML. Development of a vessel organ culture system: characterisation of the method and implications for the reduction of animal experiments. Altern Lab Anim 2013; 41:259-69. [PMID: 24168133 DOI: 10.1177/026119291304100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the field of cardiovascular research, the pig is considered to be an excellent animal model of human diseases. It is well-known that primary cultures of endothelial cells (ECs) are a powerful tool for the study of vascular physiology and pathology, and, according to the principles of the Three Rs, their use results in a substantial reduction in the numbers of experimental animals required. However, a limitation of EC culture is that the cells are not in their physiological context. Here, we describe and characterise a method for the culture of porcine vessels that overcomes the limitation of EC cultures, with the advantage of reducing the number of animals used for research purposes. The organ cultures were set-up by using an aortic cylinder obtained from the arteries of control pigs sacrificed for other experimental purposes. In order to characterise the method, vascular endothelial growth factor (VEGF) secretion, matrix metalloproteinase (MMP) activation and the vessel's structural features were evaluated during organ culture. These analyses confirm that the culture of aortic cylinder lumen, in a medium specific for ECs, results in a stable system in terms of VEGF and MMP secretion. The ECs do not undergo cell division during the organ culture, which is also the case in vivo, if no stimulation occurs. Overall, we show that this novel system closely resembles the in vivo context. Importantly, porcine aortas can be collected from either veterinary surgeries or slaughterhouses, without having to sacrifice animals specifically for the purposes of this type of research.
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Affiliation(s)
- Andrea Zaniboni
- Department of Veterinary Medical Sciences - DIMEVET, University of Bologna, Bologna, Italy
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13
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Early outcomes of the intraluminal flow guard device for secondary renal access. J Vasc Access 2012; 14:131-4. [PMID: 23172173 DOI: 10.5301/jva.5000114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2012] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The Flixene Intraluminal Flow Guard (IFG) is a novel arteriovenous graft for use in complex renal access patients. The IFG is a PTFE graft with a covered nitinol stent at the venous end implanted into the axillary vein rather than anastomosed. The purported benefits are improved hemodynamic flow in the vein with reduced neointimal hyperplasia. Our primary aim was to assess its early patency and complications. Our center is the first to publish early outcomes. METHODS All patients on whom we would have otherwise performed a standard brachial-axillary graft from April to November 2011 were instead given an IFG graft if they were suitable and consented. The only exclusion criteria was an axillary vein size under 5.5 mm as this would not accommodate the intraluminal stent graft. Data were collected prospectively and follow-up was identical to our usual graft surveillance. RESULTS A total of 12 patients (mean age 64, mean follow-up 393 days) had IFG grafts implanted during the study period. There were no exclusions and all patients consented. All patients were having secondary access following previous failed fistulae or grafts and no patient had an autogenous hemodialysis option. On average each patient had already had 1.1 previous ipsilateral access procedures. Mean operating time was 109 minutes. Functional patency at one year was 65.6%, with a mean functional patency of 162 days. There was only one early complication (wound hematoma) and one graft infection requiring explantation. CONCLUSIONS The IFG device provides an alternative to standard brachial-axillary grafts and brings similar early patency and complication profile. Continued monitoring of outcomes, however, is required to determine long-term results.
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