Paclitaxel-coated expanded polytetrafluoroethylene haemodialysis grafts inhibit neointimal hyperplasia in porcine model of graft stenosis
| Autor: | Sung Joo Kim, Hye Yeong Nam, Jai Young Ko, Ghee Young Kwon, Byung Ha Lee, Dae Joong Kim, Hyun-Jung Lim, Hyun Jung Jeon, Tae-Gun Kwon, Woo Kyoung Lee, Jong-Sang Park |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Paclitaxel Swine medicine.medical_treatment Urology Anastomosis In Vitro Techniques Prosthesis Design Arteriovenous Shunt Surgical Restenosis Coated Materials Biocompatible Renal Dialysis medicine.artery Medicine Animals Common carotid artery Neointimal hyperplasia Transplantation Hyperplasia business.industry Graft Occlusion Vascular medicine.disease Antineoplastic Agents Phytogenic Surgery Blood Vessel Prosthesis Stenosis Disease Models Animal medicine.anatomical_structure Fluorocarbon Polymers Nephrology Hemodialysis business Tunica Intima Artery |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 21(9) |
| ISSN: | 0931-0509 |
| Popis: | Background. The main pathology of haemodialysis graft stenosis is venous neointimal hyperplasia at graft–venous anastomoses. Neointimal hyperplasia is also observed in cases of coronary artery in-stent restenosis. Paclitaxel is a chemotherapeutic agent used to treat cancer, and has been proven to inhibit neointimal hyperplasia of coronary artery in-stent restenosis. In this study, we examined whether a paclitaxel-coated haemodialysis graft could inhibit neointimal hyperplasia and prevent stenosis. Methods. We dip-coated paclitaxel on expanded polytetrafluoroethylene (ePTFE) grafts at a dose density of 0.59mg/mm 2 . In vitro release tests showed an initial paclitaxel burst followed by a long-term slow release. Using ePTFE grafts with (coated group, n ¼ 8) or without a paclitaxel coating (control group, n ¼ 11), we constructed arteriovenous (AV) grafts connecting the common carotid artery and the external jugular vein in Landrace pigs. Results. After excluding seven pigs for technical failure, cross-sections of graft–venous anastomoses obtained 6 weeks after placing the AV grafts were analysed. Percentage luminal stenosis, ratios of intima to media in whole cross-sections, areas of intima in the peri-junctional areas (within 2 mm above and 2 mm below the graft–venous junction), and the mean thickness of intima within venous sides of crosssections, were 60.5% (range, 41.5–60.7), 13.0 (range, 8.6–20.4), 23.7 mm 2 (range, 10.8–32.1) and 2.1 mm (range, 1.1–3.0), respectively, in the control group, whereas corresponding median values in the coated group were 10.4% (range, 1.0–17.8), 1.0 (range, 0.7–5.1), 1.6 mm 2 (range, 0.2–8.0) and 0.3 mm (range, 0.1–2.2). All parameters were significantly different between the two groups (P |
| Databáze: | OpenAIRE |
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