Porcine carotid artery replacement with biodegradable electrospun poly-e-caprolactone vascular prosthesis
| Autor: | Sarra de Valence, Ebrahim Khabiri, Jean-Christophe Tille, Michael Möller, Mustafa Cikirikcioglu, Wojciech Mrówczyński, Beat H. Walpoth, Damiano Mugnai |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Neointima
medicine.medical_specialty Time Factors Swine Polyesters Nanofibers Activated clotting time ddc:616.07 Prosthesis Design Blood Vessel Prosthesis Implantation chemistry.chemical_compound Blood vessel prosthesis Absorbable Implants medicine Animals Vascular Patency Thrombus Polytetrafluoroethylene Tissue Scaffolds medicine.diagnostic_test ddc:617 business.industry Anticoagulants Ultrasonography Doppler Perioperative medicine.disease Blood Vessel Prosthesis Surgery Radiography Carotid Arteries chemistry Hemostasis Models Animal business Cardiology and Cardiovascular Medicine Blood Flow Velocity Platelet Aggregation Inhibitors |
| Zdroj: | Journal of Vascular Surgery, Vol. 59, No 1 (2014) pp. 210-219 |
| ISSN: | 0741-5214 |
| Popis: | ObjectiveThere is a continuous search for shelf-ready small-caliber vascular prostheses with satisfactory early and late results. Biodegradable scaffolds, repopulated by recipient's cells regenerating a neovessel, can be a suitable option for adult and pediatric, urgent and elective cardiovascular procedures.MethodsThis was a short-term experimental assessment of a new biodegradable vascular prosthesis for arterial replacement in the pig. Eleven pigs underwent bilateral carotid artery replacement with biodegradable electrospun poly-ε-caprolactone (PCL) nanofiber prostheses (internal diameter, 4 mm; length, 5 cm); or expanded polytetrafluoroethylene (ePTFE) prostheses as control. Perioperative anticoagulation was achieved with intravenous heparin (double baseline activated clotting time). Postoperatively, until conclusion of the study at 1 month, animals received aspirin and clopidogrel daily. Transit time flow was measured intraoperatively and at sacrifice. Doppler ultrasound (1 and 4 weeks) and a selective carotid angiography (4 weeks) were performed to assess patency. All explanted grafts were analyzed by histology, morphometry, and scanning electron microscopy in order to study graft-host interaction.ResultsSurgical handling and hemostasis of the new prostheses were excellent. Patency rate was 78% (7/9) for PCL grafts, compared with 67% (4/6) for ePTFE grafts. Transit time flow and Doppler ultrasound showed no significant changes in flow and velocity or diameter over time in both groups. Both prostheses showed no detectable in vivo compliance as compared with native carotid artery. Percent neoendothelialization was 86% for PCL and 58% for ePTFE grafts (P = .008). Neointima formation was equal in both grafts. More adventitial infiltration of macrophages, myofibroblasts, and capillaries was seen in PCL grafts with a milder foreign-body reaction when compared with ePTFE implants. Both grafts showed similar endoluminal thrombus formation.ConclusionsBiodegradable, electrospun PCL grafts showed good surgical and mechanical properties, no aneurysm formation, and similar short-term patency compared with ePTFE grafts. Rapid endothelialization and cell ingrowth confirms favorable PCL graft-recipient biological interaction. Despite good early results, long-term follow-up is required before clinical application.Clinical RelevanceExpanded polytetrafluoroethylene vascular grafts provide excellent mechanical and handling properties. However, their late postimplant performance is poor due to nonhomogeneous endothelialisation, intimal hyperplasia - substrates of thrombotic occlusion. Drawbacks of expanded polytetrafluoroethylene prostheses are connected with their bioinertness and could be overcome by introduction of biodegradable vascular implants that provide an artificial scaffold for complete vessel regeneration via in vivo tissue engineering. Poly-e-caprolactone prostheses have already demonstrated satisfactory performance showing rapid and complete endothelialization, colonization by different recipients' cell and extracellular matrix reconstruction. This proves an ability of integration with the host tissues providing potentially better performance than biostable vascular grafts. |
| Databáze: | OpenAIRE |
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