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Ribaudo JG, He K, Madira S, Young ER, Martin C, Lu T, Sacks JM, Li X. Sutureless vascular anastomotic approaches and their potential impacts. Bioact Mater 2024; 38:73-94. [PMID: 38699240 PMCID: PMC11061647 DOI: 10.1016/j.bioactmat.2024.04.003] [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: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Sutureless anastomotic devices present several advantages over traditional suture anastomosis, including expanded global access to microvascular surgery, shorter operation and ischemic times, and reduced costs. However, their adaptation for arterial use remains a challenge. This review aims to provide a comprehensive overview of sutureless anastomotic approaches that are either FDA-approved or under investigation. These approaches include extraluminal couplers, intraluminal devices, and methods assisted by lasers or vacuums, with a particular emphasis on tissue adhesives. We analyze these devices for artery compatibility, material composition, potential for intimal damage, risks of thrombosis and restenosis, and complications arising from their deployment and maintenance. Additionally, we discuss the challenges faced in the development and clinical application of sutureless anastomotic techniques. Ideally, a sutureless anastomotic device or technique should eliminate the need for vessel eversion, mitigate thrombosis through either biodegradation or the release of antithrombotic drugs, and be easily deployable for broad use. The transformative potential of sutureless anastomotic approaches in microvascular surgery highlights the necessity for ongoing innovation to expand their applications and maximize their benefits.
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Affiliation(s)
- Joseph G. Ribaudo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Kevin He
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Sarah Madira
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Emma R. Young
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Cameron Martin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Tingying Lu
- Department of Plastic Surgery, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Justin M. Sacks
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Xiaowei Li
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
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2
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Ito T, Mizuta R, Ito S, Taguchi T. Robust aortic media adhesion using hydrophobically modified Alaska pollock gelatin-based adhesive for aortic dissections. J Biomed Mater Res B Appl Biomater 2024; 112:e35361. [PMID: 38247245 DOI: 10.1002/jbm.b.35361] [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: 07/07/2023] [Revised: 11/11/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024]
Abstract
Type-A aortic dissection is an acute injury involving the delamination of the aorta at the parts of the aortic media. Aldehyde crosslinker-containing glues have been used to adhere to the media of the dissected aorta before joining an artificial graft. These glues effectively adhere to the aortic media; however, they show low biocompatibility due to the release of aldehyde compounds. In this study, we report innovative adhesives based on hydrophobically modified Alaska pollock gelatin (hm-ApGltn) with different alkyl or cholesteryl (Chol) groups that adhere to the media of the dissected aorta by combining hm-ApGltns with a biocompatible crosslinker, pentaerythritol poly(ethylene glycol) ether tetrasuccinimidyl glutarate. The modification of alkyl or Chol groups contributed to enhanced adhesion strength between porcine aortic media. The adhesion strength increased with increasing modification ratios of alkyl groups from propanoyl to dodecanoyl groups and then decreased at a modification ratio of ~20 mol %. Porcine aortic media adhered using 7.5Chol-ApGltn adhesive showed stretchability even when expanded and shrunk vertically by 25% at least five times. Hm-ApGltn adhesives subcutaneously injected into the backs of mice showed no severe inflammation and were degraded during the implantation period. These results indicated that hm-ApGltn adhesives have potential applications in type-A aortic dissection.
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Affiliation(s)
- Temmei Ito
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
- Biomaterials Field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, Tsukuba, Japan
| | - Ryo Mizuta
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
- Biomaterials Field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, Tsukuba, Japan
| | - Shima Ito
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
- Biomaterials Field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, Tsukuba, Japan
| | - Tetsushi Taguchi
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
- Biomaterials Field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, Tsukuba, Japan
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Fitzgerald DM, Colson YL, Grinstaff MW. Synthetic Pressure Sensitive Adhesives for Biomedical Applications. Prog Polym Sci 2023; 142:101692. [PMID: 37273788 PMCID: PMC10237363 DOI: 10.1016/j.progpolymsci.2023.101692] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Pressure sensitive adhesives are components of everyday products found in homes, offices, industries, and hospitals. Serving the general purpose of fissure repair and object fixation, pressure sensitive adhesives indiscriminately bind surfaces, as long as contact pressure is administered at application. With that being said, the chemical and material properties of the adhesive formulation define the strength of a pressure sensitive adhesive to a particular surface. Given our increased understanding of the viscoelastic material requirements as well as the intermolecular interactions at the binding interface required for functional adhesives, pressure sensitive adhesives are now being explored for greater use. New polymer formulations impart functionality and degradability for both internal and external applications. This review highlights the structure-property relationships between polymer architecture and pressure sensitive adhesion, specifically for medicine. We discuss the rational, molecular-level design of synthetic polymers for durable, removable, and biocompatible adhesion to wet surfaces like tissue. Finally, we examine prevalent challenges in biomedical wound closure and the new, innovative strategies being employed to address them. We conclude by summarizing the progress of current research, identifying additional clinical opportunities, and discussing future prospects.
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Affiliation(s)
- Danielle M. Fitzgerald
- Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA 02115
| | - Yolonda L. Colson
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02214
| | - Mark W. Grinstaff
- Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA 02115
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4
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Gheorghiță D, Moldovan H, Robu A, Bița AI, Grosu E, Antoniac A, Corneschi I, Antoniac I, Bodog AD, Băcilă CI. Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances. Int J Mol Sci 2023; 24:10540. [PMID: 37445718 DOI: 10.3390/ijms241310540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Hemorrhage is a detrimental event present in traumatic injury, surgery, and disorders of bleeding that can become life-threatening if not properly managed. Moreover, uncontrolled bleeding can complicate surgical interventions, altering the outcome of surgical procedures. Therefore, to reduce the risk of complications and decrease the risk of morbidity and mortality associated with hemorrhage, it is necessary to use an effective hemostatic agent that ensures the immediate control of bleeding. In recent years, there have been increasingly rapid advances in developing a novel generation of biomaterials with hemostatic properties. Nowadays, a wide array of topical hemostatic agents is available, including chitosan-based biomaterials that have shown outstanding properties such as antibacterial, antifungal, hemostatic, and analgesic activity in addition to their biocompatibility, biodegradability, and wound-healing effects. This review provides an analysis of chitosan-based hemostatic biomaterials and discusses the progress made in their performance, mechanism of action, efficacy, cost, and safety in recent years.
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Affiliation(s)
- Daniela Gheorghiță
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Horațiu Moldovan
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania
| | - Alina Robu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Ana-Iulia Bița
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Elena Grosu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Iuliana Corneschi
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Iulian Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania
| | - Alin Dănuț Bodog
- Faculty of Medicine and Pharmacy, University of Oradea, 10 P-ta 1 December Street, 410073 Oradea, Romania
| | - Ciprian Ionuț Băcilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 10 Victoriei Boulevard, 550024 Sibiu, Romania
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Abbas AM, Damron TA. Shoulder Pseudo-Tumor from COVID-19 Vaccine. Vaccines (Basel) 2023; 11:vaccines11040793. [PMID: 37112705 PMCID: PMC10145291 DOI: 10.3390/vaccines11040793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Hypersensitivity reactions to the COVID-19 mRNA vaccines were identified in the initial 2020 trials. Appearance of a soft tissue mass is a rare manifestation of this hypersensitivity reaction. In this patient, bilateral injections resulted in the appearance of shoulder masses. Magnetic resonance imaging showed localized pseudo-tumorous edema in both shoulders, one subcutaneous and the other intramuscular. This is only the second case of a mass-like reaction to the COVID-19 vaccine mimicking a possible soft tissue neoplasm. Improper vaccination administration technique may have contributed to this complication. The case is presented to increase awareness of this potential pseudotumor.
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Affiliation(s)
- Anas M Abbas
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, USA
| | - Timothy A Damron
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY 13057, USA
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6
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Dhandapani V, Ringuette V, Desrochers M, Sirois M, Vermette P. Composition, host responses and clinical applications of bioadhesives. J Biomed Mater Res B Appl Biomater 2022; 110:2779-2797. [PMID: 35748414 DOI: 10.1002/jbm.b.35113] [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: 02/10/2022] [Revised: 05/08/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022]
Abstract
Bioadhesives are medical devices used to join or seal tissues that have been injured or incised. They have been classified into tissue adhesives, sealants, and hemostatic agents. Bioadhesives such as FloSeal®, CoSeal®, BioGlue®, Evicel®, Tisseel®, Progel™ PALS, and TissuGlu® have been commercialized and used in clinical setting. They can be formulated with natural or synthetic components or a combination of both including albumin, glutaraldehyde, chitosan, cyanoacrylate, fibrin and thrombin, gelatin, polyethylene glycol (PEG), along with urethanes. Each formulation has intrinsic properties and has been developed and validated for a specific application. This review article briefs the mechanisms by which bioadhesives forms adhesion to tissues and highlights the correlation between bioadhesives composition and their potential host responses. Furthermore, clinical applications of bioadhesives and their application-driven requirements are outlined.
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Affiliation(s)
- Vignesh Dhandapani
- Department of Chemical and Biotechnological Engineering, Laboratoire de bio-ingénierie et de biophysique de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Faculté de médecine et des sciences de la santé, Centre de Recherche du CHUS, Sherbrooke, Québec, Canada
| | - Vickie Ringuette
- Department of Surgery, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Monika Desrochers
- Department of Chemical and Biotechnological Engineering, Laboratoire de bio-ingénierie et de biophysique de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Marco Sirois
- Faculté de médecine et des sciences de la santé, Centre de Recherche du CHUS, Sherbrooke, Québec, Canada.,Department of Surgery, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Patrick Vermette
- Department of Chemical and Biotechnological Engineering, Laboratoire de bio-ingénierie et de biophysique de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Faculté de médecine et des sciences de la santé, Centre de Recherche du CHUS, Sherbrooke, Québec, Canada
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Quintero D, Patel N, Harris G, Maristany A, Alani A, Rosenberg AE, Conway SA, Jose J. COVID-19 vaccine-associated ganulomatous mass mimicking a sarcoma: a case report. Radiol Case Rep 2022; 17:2775-2778. [PMID: 35677708 PMCID: PMC9165447 DOI: 10.1016/j.radcr.2022.05.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/02/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022] Open
Abstract
Several studies have previously documented the development of complications stemming from injection with one of the various COVID-19 vaccines. No study, however, has discussed the spontaneous development of a soft tissue mass shortly after a COVID-19 vaccine injection. We report on 66-year-old female with concerns of a growing shoulder mass, 2 weeks after receiving a COVID-19 vaccine booster. Initial work-up with X-ray and MRI was concerning for a soft tissue neoplasm, specifically a soft tissue sarcoma. Subsequent ultrasound guided biopsy demonstrated a benign granulomatous lesion. No further management was required as the lesion spontaneously resolved during a 3-month follow-up period.
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Affiliation(s)
- Daniel Quintero
- University of Miami Leonard Miller School of Medicine, Miami, FL, USA
- University of Miami, Leonard Miller School of Medicine, Department of Orthopedic Surgery, Miami, FL, USA
- Corresponding author.
| | - Nikhil Patel
- University of Miami Leonard Miller School of Medicine, Miami, FL, USA
| | - Griffin Harris
- University of Miami Leonard Miller School of Medicine, Miami, FL, USA
| | - Anthony Maristany
- Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Ali Alani
- University of Miami, Leonard Miller School of Medicine, Department of Pathology, Miami, FL, USA
| | - Andrew E Rosenberg
- University of Miami, Leonard Miller School of Medicine, Department of Pathology, Miami, FL, USA
| | - Sheila A Conway
- University of Miami, Leonard Miller School of Medicine, Department of Orthopedic Surgery, Miami, FL, USA
| | - Jean Jose
- University of Miami, Leonard Miller School of Medicine, Department of Radiology, Miami, FL, USA
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8
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Medical Adhesives and Their Role in Laparoscopic Surgery—A Review of Literature. MATERIALS 2022; 15:ma15155215. [PMID: 35955150 PMCID: PMC9369661 DOI: 10.3390/ma15155215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/15/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023]
Abstract
Laparoscopic surgery is undergoing rapid development. Replacing the traditional method of joining cut tissues with sutures or staples could greatly simplify and speed up laparoscopic procedures. This alternative could undoubtedly be adhesives. For decades, scientists have been working on a material to bond tissues together to create the best possible conditions for tissue regeneration. The results of research on tissue adhesives achieved over the past years show comparable treatment effects to traditional methods. Tissue adhesives are a good alternative to surgical sutures in wound closure. This article is a review of the most important groups of tissue adhesives including their properties and possible applications. Recent reports on the development of biological adhesives are also discussed.
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9
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The effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on local tissue reaction and inflammation in rabbit carotid artery anastomosis. Vascular 2022; 31:554-563. [DOI: 10.1177/17085381221075484] [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
Objectives In addition to the hemostatic properties of hemostatic agents, the investigation of their immunogenic properties, their local effects on application area has been the subject of many experimental studies. There are limited data on the inflammatory effects of Bovine serum albumin-glutaraldehyde and Polyethylene glycol polymer. Therefore, we investigated the effects of these agents on tissue reactions and inflammation in rabbit carotid artery anastomosis in our experimental study. Methods Twenty-one New Zealand male rabbits were randomly divided into three groups. The right carotid artery anastomosis was performed on the control group after transection. Hemostatic agents were applied locally to other two groups separately after transection and anastomosis. At the end of 28 days, the type of inflammation, inflammatory cell infiltration, degree of inflammation, and amount of residual adhesives were examined and compared statistically. Results Cell infiltrations associated with inflammation on the anastomosis site (eosinophils, epithelioid/giant cells, lymphocytes, and plasma cells) and inflammation grade in the groups of hemostatic agents were significantly lower compared to the control group ( p < .05). There was no difference between the hemostatic agents. While mild inflammation (61.9%) was dominant in the groups of hemostatic agents, moderate inflammation (85.7%) was more common in the control group. No severe inflammation was observed in any of the three groups. Residual sealant grade between hemostatic agents did not differ significantly. Conclusions When inflammation and tissue reactions of the 4th week were evaluated, it was determined that both hemostatic agents did not cause severe inflammation. However, comparative results at multiple time intervals are needed due to the dynamic process of inflammation.
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Gohbara M, Sugano T, Ishikawa T, Tamura K, Kimura K. A case of a coronary covered stent for repeated restenosis at the anastomosis site between saphenous vein graft and graft prosthesis. J Cardiol Cases 2022; 25:110-114. [PMID: 35079311 DOI: 10.1016/j.jccase.2021.07.007] [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: 06/11/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022] Open
Abstract
A 56-year-old man was admitted with a diagnosis of non-ST-segment elevation myocardial infarction, after surgery for total arch replacement, aortic root replacement with a mechanical aortic valve, and coronary artery reconstruction by the Piehler method for acute aortic dissection. Coronary angiography (CAG) revealed a 99% stenosis of the anastomosis site between the J Graft (Japan Lifeline, Tokyo, Japan) and the saphenous vein graft (SVG), which was distally sutured to his right coronary artery (posterior descending artery). After percutaneous coronary intervention (PCI) with a drug-eluting stent to the anastomosis site, repeated in-stent restenosis unfortunately occurred. Despite repeated PCIs, he was again admitted due to exertional angina pectoris, with proven inferior myocardial ischemia by stress myocardial perfusion imaging. We therefore decided to use a coronary covered stent for the anastomosis site to seal neointimal proliferation. GRAFTMASTER 2.8/19 mm (Abbott, CA, USA) was implanted in the anastomosis site, and a follow-up CAG one-year later revealed that the covered stent was clearly opened. To the best of our knowledge, this is the first paper to demonstrate the usefulness of a covered stent for repeated restenosis of the anastomosis site between SVG and graft prostheses. <Learning objective: A coronary covered stent is a stent with a membrane designed to seal the rupture site in cases with a coronary rupture. However, coronary covered stent implantation is an optional method in cases with repeated restenosis of the anastomosis site between the saphenous vein graft and graft prosthesis.>.
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Affiliation(s)
- Masaomi Gohbara
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Teruyasu Sugano
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Toshiyuki Ishikawa
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuo Kimura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
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Mohamed MS. Evaluation of mesenchymal stem cells in the healing of anastomosed carotid arteries. AMERICAN JOURNAL OF STEM CELLS 2021; 10:53-55. [PMID: 34552817 PMCID: PMC8449140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
Cell therapies could be the future of medicine. Many centers worldwide consider the use of stem cells to treat certain conditions. Well, proper homing remains the challenge, which means the ability to target the cells to the targeted site. Intraoperative transplantation of stem cells can overcome the homing challenge. However, it could be a double-edged sword, if a proper technique was not conducted. In this comment, a practical example of that is presented, where the use of stem cells in the vascular and neurovascular surgeries shows a promising potential, but the way in which the cells are processed and introduced is a critical step that should be given a lot of attention.
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Keskin E, Aydın HA, Kalaycı M, Işık E, Özgen U, Şimşek K, Baklacı D, Gökçe M. The histopathological effects of reabsorbable polyethylene glycol hydrogel (Coseal) on epidural fibrosis in an experimental postlaminectomy model in rats. Turk J Med Sci 2021; 51:1512-1520. [PMID: 33453711 PMCID: PMC8283455 DOI: 10.3906/sag-2009-241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/16/2021] [Indexed: 12/14/2022] Open
Abstract
Background/aim To investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal) on epidural fibrosis (EF) following laminectomy in rats. Materials and methods A total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF. Results The results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3. Conclusion Intraoperative Coseal, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.
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Affiliation(s)
- Emrah Keskin
- Department of Neurosurgery, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Hasan Ali Aydın
- Department of Neurosurgery, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Murat Kalaycı
- Department of Neurosurgery, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Emre Işık
- Department of Pathology, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Utku Özgen
- Department of Neurosurgery, Atatürk State Hospital, Zonguldak, Turkey
| | - Kenan Şimşek
- Department of Neurosurgery, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Deniz Baklacı
- Department of Otorhinolaryngology, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Mertol Gökçe
- Department of Thoracic Surgery, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
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13
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Fife A, Khouri OR, Grantham M, DiVito J, Hébert T, Kuo DYS. Inflammatory reaction to BioGlue™ masquerading as recurrence in patients with endometrial cancer: A report of two cases. Gynecol Oncol Rep 2020; 34:100665. [PMID: 33251313 PMCID: PMC7680770 DOI: 10.1016/j.gore.2020.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/20/2020] [Accepted: 10/25/2020] [Indexed: 11/20/2022] Open
Abstract
BioGlue™, a glutaraldehyde-based vessel sealant, can cause a foreign body reaction. Vessel sealants may be used for IVC repair during endometrial cancer staging. Foreign body reaction to BioGlue™ may look like a cancer recurrence on imaging. It is important to note prior use of vessel sealants in assessing paraaortic recurrence.
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Affiliation(s)
- Alexander Fife
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Olivia R. Khouri
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
- Corresponding author at: Division of Gynecologic Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Department of Obstetrics, Gynecology and Women’s Health, 1695 Eastchester Road, Bronx, NY 10467, United States.
| | - Mica Grantham
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Joseph DiVito
- Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Tiffany Hébert
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Dennis Yi-Shin Kuo
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
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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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