Clinical autologous in vitro endothelialization of 153 infrainguinal ePTFE grafts

Meinhart, Johann; Deutsch, Manfred; Fischlein, T; Howanietz, Norbert; Fröschl, A; Zilla, Peter

doi:10.1016/s0003-4975(01)02555-3

Cited by 239 publications

(144 citation statements)

References 13 publications

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“…1,2 The importance of the endothelial monolayer to graft patency has been demonstrated by the ability of this monolayer to provide superior patency for prosthetic grafts. 45 Because chronic exposure to arterial magnitudes of shear stress increases the ability of endothelial cells lining vascular grafts to adhere to their underlying substratum, 46,47 our finding of a preserved endothelial monolayer in our model (supplemental Figure III) suggests that endothelial cells may be the source of early VEGF-A expression in vein grafts (Figure 4). This is also consistent with our finding of a confluent monolayer in patent human vein grafts (supplemental Figure IA), as well as downregulated expression of the VEGF receptor ( Figure 4C).…”

Section: Kudo Et Almentioning

confidence: 75%

Venous Identity Is Lost but Arterial Identity Is Not Gained During Vein Graft Adaptation

Kudo

Muto

Maloney

et al. 2007

ATVB

110

116

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Objectives— Ephrin ligands and Eph receptors are signaling molecules that are differentially expressed on arteries and veins during development. We examined whether Eph-B4, a venous marker, and Ephrin-B2, an arterial marker, are regulated during vein graft adaptation in humans and aged rats. Methods and Results— Eph-B4 transcripts and immunodetectable protein are downregulated in endothelial and smooth muscle cells of patent vein grafts in both humans and in aged rats, whereas Ephrin-B2 transcripts and protein are not strongly induced. Other markers of arterial identity, including dll4 and notch-4, are also not induced during vein graft adaptation in aged rats. Because VEGF-A is upstream of the Ephrin–Eph pathway, and expression of VEGF-A is induced only at early time points after exposure of the vein to the arterial environment, we inhibited VEGF-A in vein grafts using an siRNA-based approach. Vein grafts treated with siRNA directed against VEGF-A demonstrated a thicker intima-media containing α-actin, consistent with arterialization, but did not contain Eph-B4 or Ephrin-B2. Conclusions— Venous identity is preserved in the veins of aged animals, but is lost during adaptation to the arterial circulation; arterial markers are not induced. Markers of vessel identity are plastic in adults and their selective regulation may mediate vein graft adaptation to the arterial environment in aged animals and humans.

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Section: Kudo Et Almentioning

confidence: 75%

Venous Identity Is Lost but Arterial Identity Is Not Gained During Vein Graft Adaptation

Kudo

Muto

Maloney

et al. 2007

ATVB

110

116

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“…The engineered vessels are then decellular- seeded control group. 41 These results highlight the desirability of an EC layer in vascular grafts, but direct EC-seeding of synthetic ePTFE conduits is challenging, costly, and may offer only a slight advantage to the patient.…”

Section: Sheet-based Techniquesmentioning

confidence: 86%

Vessel Bioengineering

Tara

Rocco

Hibino

et al. 2014

Circ J

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The development of vascular bioengineering has led to a variety of novel treatment strategies for patients with cardiovascular disease. Notably, combining biodegradable scaffolds with autologous cell seeding to create tissue-engineered vascular grafts (TEVG) allows for in situ formation of organized neovascular tissue and we have demonstrated the clinical viability of this technique in patients with congenital heart defects. The role of the scaffold is to provide a temporary 3-dimensional structure for cells, but applying TEVG strategy to the arterial system requires scaffolds that can also endure arterial pressure. Both biodegradable synthetic polymers and extracellular matrixbased natural materials can be used to generate arterial scaffolds that satisfy these requirements. Furthermore, the role of specific cell types in tissue remodeling is crucial and as a result many different cell sources, from matured somatic cells to stem cells, are now used in a variety of arterial TEVG techniques. However, despite great progress in the field over the past decade, clinical effectiveness of small-diameter arterial TEVG (<6 mm) has remained elusive. To achieve successful translation of this complex multidisciplinary technology to the clinic, active participation of biologists, engineers, and clinicians is required. (Circ J 2014; 78: 12 -19)

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“…Endothelial regeneration after injury can be promoted by the local delivery of potent growth factor genes or by the growth factors themselves. The importance of the endothelium is supported clinically by the improvement Zilla et al showed in prosthetic graft patency and function after EC seeding compared to unseeded grafts [94,95]. This is probably the most obvious way to promote a confluent endothelium, and it can be used at sites of intimal disruption [96] or on prosthetic grafts as reviewed by Parikh and Edelman in 2000 [97].…”

Section: Promoting a Functional Endotheliummentioning

confidence: 99%

Cardiovascular gene delivery: The good road is awaiting☆

Brewster

Brey

Greisler

2006

Advanced Drug Delivery Reviews

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Atherosclerotic cardiovascular disease is a leading cause of death worldwide. Despite recent improvements in medical, operative, and endovascular treatments, the number of interventions performed annually continues to increase. Unfortunately, the durability of these interventions is limited acutely by thrombotic complications and later by myointimal hyperplasia followed by progression of atherosclerotic disease over time. Despite improving medical management of patients with atherosclerotic disease, these complications appear to be persisting. Cardiovascular gene therapy has the potential to make significant clinical inroads to limit these complications. This article will review the technical aspects of cardiovascular gene therapy; its application for promoting a functional endothelium, smooth muscle cell growth inhibition, therapeutic angiogenesis, tissue engineered vascular conduits, and discuss the current status of various applicable clinical trials.

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Clinical autologous in vitro endothelialization of 153 infrainguinal ePTFE grafts

Cited by 239 publications

References 13 publications

Venous Identity Is Lost but Arterial Identity Is Not Gained During Vein Graft Adaptation

Venous Identity Is Lost but Arterial Identity Is Not Gained During Vein Graft Adaptation

Vessel Bioengineering

Cardiovascular gene delivery: The good road is awaiting☆

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