Clinical experience with autologous endothelial cell–seeded polytetrafluoroethylene coronary artery bypass grafts

Laube, Horst; Duwe, Jan; Rutsch, Wolfgang; Konertz, Wolfgang

doi:10.1067/mtc.2000.106327

Cited by 137 publications

(79 citation statements)

References 22 publications

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“…20 Using the 2-stage "sodding" technique has improved clinical results, but requires long-term endothelial cell culture (4 to 6 weeks). 21,22 A second obstacle in endothelialization of grafts is the poor retention of seeded cells. Human endothelial cells show little adhesion to the currently available vascular graft materials.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Forces Enable Rapid Endothelialization of Synthetic Vascular Grafts

et al. 2006

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Background-Synthetic vascular grafts cannot be used in small vessels because of graft failure caused by thrombosis and neointima formation. Rapid endothelialization may overcome this limitation. We hypothesized that a magnetic graft would be able to capture and retain endothelial cells labeled with paramagnetic particles. Methods and Results-Porcine blood derived endothelial cells were allowed to endocytose superparamagnetic iron oxide microspheres. Cell survival was assessed by trypan blue exclusion and demonstrated a dose-dependent cell survival of 75% to 95%. A flexible magnetic sheet was annealed to the external surface of a knitted Dacron graft. Labeled cells (10 6 /mL) were placed within the graft for 5 minutes. Confocal and electron microscopy confirmed uniform cell capture at the magnetized surface. The effect of shear forces on the adherent cells was evaluated in a flow chamber. The cells remained attached at rates up to 300 mL/min, with cell loss commencing at 400 mL/min. Prototype magnetic grafts were implanted in porcine carotid arteries. Labeled cells were placed within the graft for 10 minutes at the time of implantation. The grafts were evaluated after one day and uniform cell coverage was noted on the magnetized surface. In comparison, relatively few labeled cells were seen attached to a nonmagnetized surface. Key Words: coronary disease Ⅲ endothelium Ⅲ grafting Ⅲ surgery Ⅲ magnet T he major limitation of prosthetic vascular grafts is their tendency to occlude after various periods of time. This occlusion rate is higher for smaller-diameter grafts and precludes their use in a significant number of medical applications, most notably in coronary artery bypass grafting. Numerous studies have shown that failure is secondary to graft occlusion, either because of thrombogenicity of the synthetic material or because of encroachment of tissue (intimal hyperplasia) into the lumen of the graft at anastomotic sites. 1 A potential way to limit graft failure would be to provide rapid, uniform, and complete coverage with a functional endothelial layer. In a pioneering study, Stump et al have shown that a Dacron patch suspended in the flow, without contact with the vessel wall, was covered with endothelial colonies within 7 days of implantation. 2 Early efforts at graft endothelialization with the use of mature endothelial cells, 3-8 although promising, were limited by difficulties related to obtaining cells in significant numbers. The recent description of circulating endothelial progenitor cells 9 has provided a new source for cellular seeding of grafts. We have previously shown that blood-derived endothelial outgrowth cells (EOCs) are effective in preventing restenosis and can restore vascular function in animal models of arterial injury. 10 Previous work used prolonged vascular occlusion to enable cell adhesion to the vessel wall, an approach that cannot be used in clinical settings. We hypothesized that local cell capture and retention could be accomplished by using magnetic forces. EOCs were rendered magn...

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Section: Discussionmentioning

confidence: 99%

Magnetic Forces Enable Rapid Endothelialization of Synthetic Vascular Grafts

et al. 2006

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“…[6][7][8] Over the past 50 years, clinical studies have indicated that the endothelial cells (ECs)-seeded grafts have high patency rate in human cardiac artery and lower extremity artery bypass grafting. 9,10 Despite such successful results, the clinical application of the ECs-seeded graft was still hampered by the lack of a convenient source of ECs. 11 During the last decade, fortunately, the discovery of endothelial progenitor cells (EPCs) has opened up vistas to possible TEVGs with these cells.…”

Section: Introductionmentioning

confidence: 99%

Development and In Vivo Evaluation of Small-Diameter Vascular Grafts Engineered by Outgrowth Endothelial Cells and Electrospun Chitosan/Poly(ɛ-Caprolactone) Nanofibrous Scaffolds

Zhou

Qiao

Zhao

et al. 2014

Tissue Engineering Part A

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“…So far, many researchers have described seeding endothelial cells in conduits. A recent study reported a patency rate of 90% in 27 months for ePTFE prostheses used in coronary bypass, after additional incubation with endothelial cells which allowed them to adhere to the material (Laube HR et al 2000). The major limitation of this method is the need for cell cultures and withdrawal of tissue from the patient, and in any case it remains a two-step procedure.…”

Section: Materials Surfacementioning

confidence: 99%