Recent advances in understanding the interaction between electricity and cells/biomolecules have generated great interest in developing biocompatible electrically conductive materials. In this study, we investigated the biocompatibility of a myo-inositol hexakisphosphate gelated polyaniline hydrogel using in vitro and in vivo experiments in a rat model. The polyaniline hydrogel was used to coat a polycaprolactone scaffold and was cultured with rat endothelial progenitor cells differentiated from rat adipose-derived stem cells. Compared with the control sample on a pristine polycaprolactone scaffold, the treated polyaniline hydrogel had the same non-poisonous/cytotoxicity grade, enhanced cell adhesion, and a higher cell proliferation/growth rate. In implant studies, the polyaniline hydrogel sample induced milder inflammatory responses than did the control at the same time points. Combining the advantages of a biocompatible hydrogel and an organic conductor, the inositol phosphate-gelated polyaniline hydrogel could be used in bioelectronics applications such as biosensors, neural probes, cell stimulators, medical electrodes, tissue engineering, and electro-controlled drug delivery.
WHAT THIS PAPER ADDS Endovascular treatment (EVT) has favourable short-term outcomes for spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). However, evidence for this comes mainly from case reports and cohort studies with small patient numbers. This study, including 128 patients with up to five year follow up, showed that EVT was associated with a satisfactory superior mesenteric artery remodelling rate and stent patency. The cumulative event free survival rate in patients with stents was also superior to that in patents without stents, indicating that EVT could be an effective approach for SIDSMA.Objectives: Endovascular treatment (EVT) is an alternative method to treat spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). Although its short-term results are promising, few mid-term results have been reported. This study reports the five year follow up of EVT for SIDSMA. Methods: A total of 128 consecutive patients with SIDSMA admitted to the study hospital between 2011 and 2016 were enrolled in this retrospective study. Their demographic information, clinical findings, EVT outcomes, and follow up results were analysed. Results: Conservative treatment and pre-operative preparation were given immediately after admission, then digital subtraction angiography was performed. Stents were deployed in 112 out of 128 patients. The 16 patients who did not receive stents then continued conservative treatment. Peri-procedural complications occurred in three patients, including one death and two pseudoaneurysms at puncture sites. Mean follow up was 29.7 months (range 6e60 months) in patients with stents and 31.4 months (range 14e45 months) in patients without stents. During follow up, the overall complete remodelling rate in the stent group was 88.3%. Most took place within three months of stenting. The cumulative primary stent patency rate was 99.1%, and the cumulative event free survival rate was 99.0%, 95.8%, and 95.8% at one, three, and five years in patients with stents, compared with 62.5% at both one and three years in patents without stents (p < .001). Conclusions: EVT for SIDSMA is clinically successful. The event free survival rate, primary patency, and complete remodelling are satisfactory during mid-term follow up. Endovascular treatment is an effective approach for SIDSMA.
Ten patients with arch pathologies underwent ETAAR. Revascularisation of three branches was successfully performed in eight patients, but attempts to create ISF in LSA were unsuccessful in two patients because of tortuosity and sharp angle. The time taken to establish ISF in LCCA and BCT was 100.4s and 489.6s, respectively. Bilateral regional cerebral oxygen saturation (RCOS) decreased after the arch endograft deployment (both, p < .001) and recovered to the pre-operative level once both carotid arteries were reconstructed (left, p = .0856; right, p = .6). The right RCOS was higher with the beneficial effect of extracorporeal circulation (after cTAGs deployment, p < .001; after LCCA revascularised, p = .0148) during the ischaemic period. In one case, the left iliac artery ruptured, but no ISF related or neurological complications occurred. An early follow-up (mean 5.44 months) CTA and ultrasound confirmed patency of all the branch grafts without any endoleak or migration CONCLUSIONS: This study demonstrated that ETAAR via needle based ISF, making full use of off the shelf devices and techniques, can be successfully performed in aortic arch pathologies with a favourable early outcome.
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