Constrictive external nitinol meshes inhibit vein graft intimal hyperplasia in nonhuman primates

Zilla, Peter; Human, Paul; Wolf, Michael; Lichtenberg, Wilhelm; Rafiee, Nasser; Bezuidenhout, Deon; Samodien, Nazlia; Schmidt, Christian A.; Franz, Thomas

doi:10.1016/j.jtcvs.2008.02.068

Cited by 61 publications

(100 citation statements)

References 26 publications

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“…The authors reported that the vein graft that was constricted by 50% in a baboon model showed significantly suppressed intimal hyperplasia at both 6 and 12 weeks when compared to the unsupported vein grafts. Additionally, the authors demonstrated that only in the 50% constricted vein graft was endothelialization maintained (Zilla et al, 2008). Although the authors demonstrated some pulse compliance in a subsequent knitted nitinol wire mesh study, wire breakage and www.frontiersin.org a lower degree of surface endothelialization was observed (Zilla et al, 2011).…”

Section: Autologous Graftsmentioning

confidence: 97%

“…The authors adopted a loose-fitting macroporous polyglactin stent for bilateral saphenous vein into common carotid artery interposition grafting in Large White pigs. At 1 and 6 months, the stented vein grafts showed decreased neointimal and medial thickening compared to unstented controls (Vijayan et al, 2004); however, the use of relatively small saphenous veins for interposition grafts in large arteries may have created flow conditions not clinically observed in bypass graft surgery (Zilla et al, 2008).…”

Section: Autologous Graftsmentioning

confidence: 97%

“…Despite the decreased intimal hyperplasia observed with the supported vein grafts, the wire mesh supports are not biodegradable and thus, introduce the risk of future complications (Vijayan et al, 2004) should the wire supports fray, break, or undergo radial narrowing from axial distension (Zilla et al, 2008(Zilla et al, , 2011. Vijayan et al examined a polyglactin biodegradable external sheath as support for porcine saphenous vein grafts to prevent future risks from permanent stents.…”

Section: Autologous Graftsmentioning

confidence: 99%

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Vascular Grafting Strategies in Coronary Intervention

2014

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With the growing need for coronary revascularizations globally, several strategies to restore blood flow to the heart have been explored. Bypassing the atherosclerotic coronary arteries with autologous grafts, synthetic prostheses, and tissue-engineered vascular grafts continue to be evaluated in search of a readily available vascular graft with clinically acceptable outcomes. The development of such a vascular graft including tissue engineering approaches both in situ and in vitro is herein reviewed, facilitating a detailed comparison on the role of seeded cells in vascular graft patency.

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Section: Autologous Graftsmentioning

confidence: 97%

Section: Autologous Graftsmentioning

confidence: 97%

Section: Autologous Graftsmentioning

confidence: 99%

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Vascular Grafting Strategies in Coronary Intervention

2014

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“…Some stents, however, are placed around the outside of the graft, as an external, supporting sheath [17,45]. Lesions treated with internal stents have a reduced incidence of restenosis (compared with angioplasty alone) in large arteries with short lesions [46,47], but require a longer hospital stay with the possibility of more vascular complications that may not be amenable to emergency surgical correction [46,48].…”

Section: Management Strategies For Atherosclerosismentioning

confidence: 99%

Targeted Treatments for Restenosis and Vein Graft Disease

Thomas

2012

ISRN Vascular Medicine

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Surgery to restore blood flow in arteries blocked by atherosclerotic plaque is a common treatment in cardiovascular disease. Longterm complications of surgical treatment are vein graft disease and restenosis, a renarrowing of the blood vessel after bypass or removal of the culprit atherosclerotic plaque. Attempts to prevent or treat these complications by systemic pharmacological approaches have been largely unsuccessful in the clinic. This has led to an interest in developing targeted or locally delivered strategies. This paper discusses many of the various site-delivered therapies that are under examination as potential antirestenotic and antivein graft disease agents (including antithrombotic, antiproliferative, and anti-inflammatory agents) and why many therapies developed in animal models fail in clinical trials. Techniques of targeted delivery (including stents, "magic bullets," and adventitial delivery) and delivery systems (including nanoparticles and the use of gene therapy) are also discussed.

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“…Updated therapeutic strategies to alleviate restenosis or neointimal hyperplasia correspondingly have included collection and preservation of the vein, pharmacotherapy, gene therapy, radiotherapy, and laser and photodynamic therapy. 4,5 These treatments have shown inhibitory effects on restenosis in animal trials, but still have some drawbacks.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment with intraluminal rapamycin nanoparticle perfusion inhibits neointimal hyperplasia in a rabbit vein graft model

Cao²,

Zhang³

et al. 2010

IJN

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Purpose: Poly lactic-co-glycolic acid nanoparticles (PLGA-NP) are widely used as a biodegradable biomaterial in medicine. Rapamycin-eluting stents have been used for prevention of restenosis during surgery. This study investigated the effect of pretreatment with intraluminal perfusion of carbopol-encapsulated rapamycin-loaded PLGA nanoparticles (RAP-PLGA-NP) on neointimal hyperplasia in a rabbit vein graft model. Methods: A segment of common carotid artery was replaced with a segment of external jugular vein in 60 rabbits which were then separated into four treatment groups, ie, Group 1, in which vein grafts were pretreated with intraluminal RAP-PLGA-NP perfusion, Group 2 in which vein grafts underwent equivalent empty vehicle (PLGA-NP) perfusion, Group 3, in which vein grafts received no treatment, and Group 4, which served as a sham operation group receiving normal vein contrast. On postoperative day 28, the grafts and normal veins were harvested for histologic examination, flow cytometry analysis, and high-performance liquid chromatography measurement. Results: Compared with Group 1, the intima of the grafts were thickened, the ratio of intimal area to vessel area increased, and the collagen volume index of the vein grafts increased significantly in Groups 2 and 3. The cell proliferation index in Group 1 (21.11 ± 3.15%) was much lower than that in Group 2 (30.35 ± 2.69%) and in Group 3 (33.86 ± 8.72%). By highperformance liquid chromatography measurement, retention of rapamycin was detected in Group 1 (11.2 ± 0.37 µg/10 mg) 28 days after single drug perfusion. Conclusion: Pretreatment with intraluminal RAP-PLGA-NP perfusion may inhibit neointimal hyperplasia in vein grafts by penetrating into local tissue and limiting cell proliferation.

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Constrictive external nitinol meshes inhibit vein graft intimal hyperplasia in nonhuman primates

Abstract: By using an animal model that addressed the clinical phenomenon of diameter discrepancy between vein graft and bypassed artery, we could demonstrate that suppression of intimal hyperplasia required constrictive mesh sizes.

Cited by 61 publications

References 26 publications

Vascular Grafting Strategies in Coronary Intervention

Vascular Grafting Strategies in Coronary Intervention

Targeted Treatments for Restenosis and Vein Graft Disease

Pretreatment with intraluminal rapamycin nanoparticle perfusion inhibits neointimal hyperplasia in a rabbit vein graft model

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