Lower extremity arterial reconstruction in the very elderly: Successful outcome preserves not only the limb but also residential status and ambulatory function

Pomposelli, Frank B.; Arora, Subodh; Gibbons, G. W.; Frykberg, Robert G.; Smakowski, Paula; Campbell, David R.; Freeman, Dorothy V.; LoGerfo, Frank W.

doi:10.1016/s0741-5214(98)70157-0

Cited by 106 publications

(94 citation statements)

References 26 publications

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“…Currently, it is possible to replace large arteries with synthetic grafts made of materials such as polyester and expanded polytetrafluoroethylene (ePTFE) 1 ; however, their use is limited to large arteries given their thrombogenicity 2 and their high propensity to develop intimal hyperplasia (IH). [3][4][5] Development of suitable grafts to substitute for small size arteries (<6 mm in diameter), such as coronary arteries, still remains a daunting challenge. 6 Bacterial cellulose (BC) is a polysaccharide produced by Acetobacter Xylinum bacteria, which exhibits high-mechanical strength, high-water content, high crystallinity, and an ultrafine highly pure nanofibril network similar to that of collagen.…”

Section: Introductionmentioning

confidence: 99%

Bacterial cellulose as a potential vascular graft: Mechanical characterization and constitutive model development

et al. 2011

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Bacterial cellulose (BC) is a polysaccharide produced by Acetobacter Xylinum bacteria with interesting properties for arterial grafting and vascular tissue engineering including high-burst pressure, high-water content, high crystallinity, and an ultrafine highly pure fibrous structure similar to that of collagen. Given that compliance mismatch is one of the main factors contributing to the development of intimal hyperplasia in vascular replacement conduits, an in depth investigation of support mechanical properties of BC is required to further supporting its use in cardiovascular-grafting applications. The aim of this study was to mechanically characterize BC and also study its potential to accommodate vascular cells. To achieve these aims, inflation tests and uniaxial tensile tests were carried out on BC samples. In addition, dynamic compliance tests were conducted on BC tubes, and the results were compared to that of arteries, saphenous vein, expanded polytetrafluoroethylene, and Dacron grafts. BC tubes exhibited a compliance response similar to human saphenous vein with a mean compliance value of 4.27 × 10(-2) % per millimeter of mercury over the pressure range of 30-120 mmHg. In addition, bovine smooth muscle cells and endothelial cells were cultured on BC samples, and histology and fluorescent imaging analysis were carried out showing good adherence and biocompatibility. Finally, a method to predict the mechanical behavior of BC grafts in situ was established, whereby a constitutive model for BC was determined and used to model the BC tubes under inflation using finite element analysis.

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Section: Introductionmentioning

confidence: 99%

Bacterial cellulose as a potential vascular graft: Mechanical characterization and constitutive model development

et al. 2011

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“…ATHEROSCLEROTIC VASCULAR disease, in the form of coronary artery and peripheral vascular disease (PVD), is the largest cause of morbidity and mortality in both the United States and Europe (PoMPOSELLI et al, 1998). Surgical mainstays of therapy for affected vessels less than 6 mm in diameter include bypass grafting with autologous vein.…”

Section: Introductionmentioning

confidence: 99%

Cellular engineering of vascular bypass grafts: Role of chemical coatings for enhancing endothelial cell attachment

Salacinski

Tiwari

Hamilton

et al. 2001

Med. Biol. Eng. Comput.

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Surgical treatment of vascular disease has become common. The use of synthetic materials is limited to grafts larger than 5-6mm, because of the frequency of occlusion observed with small-diameter prosthetics. An alternative would be a hybrid or tissue-engineered graft with the surface coated with a monolayer of the patient's own cells. Currently, to be effective, high-density seeding regimens have to be undertaken. This is because endothelial cells (ECs) are washed off the graft lumen once exposed to physiological blood flow. EC attachment has been shown to be significantly improved by pre-coating with substances known to attach ECs selectively. The review examines the various types of coating and bonding technology used to date to enhance endothelial cell attachment onto the surface of prosthetic vascular bypass grafts.

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“…11 In addition, synthetic grafts have not been successful for small vessel implants (<5 mm), which are particularly prone to thrombosis, resulting in complete occlusion of the graft. [12][13][14] Therefore, there is great need for innovation in the design and development of novel cardiovascular prosthetics to provide a successful long-term alternative for clinical use in humans. [15][16][17][18] To circumvent some of the recurring issues in the design of vascular replacements, research is now focused on engineering de novo vascular tissue.…”

mentioning

confidence: 99%

Characterization of Endothelial Basement Membrane Nanotopography in Rhesus Macaque as a Guide for Vessel Tissue Engineering

Liliensiek

Nealey

Murphy

2009

Tissue Engineering Part A

147

117

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Basement membranes have many features that greatly influence vascular endothelial cell function, including a complex three-dimensional topography. As a first step in the design and development of vascular prosthetics, we undertook a thorough characterization of the topographic features of endothelial vascular basement membranes utilizing transmission electron microscopy and scanning electron microscopy. Specifically, we quantitatively analyzed the topographic features present in the aorta, carotid, saphenous, and inferior vena cava vessels in the rhesus macaque. Our results indicate that vascular basement membranes are composed of a complex meshwork consisting of pores and fibers in the submicron (100-1000 nm) and nanoscale (1-100 nm) range, consistent with what has previously been reported in basement membranes of other tissues. We found significant differences ( p < 0.05) in basement membrane thickness and pore and fiber diameter depending on the location and physical properties of the vessel. These results have relevance to our fundamental understanding of vascular endothelial cell-matrix interactions in health and disease, evolving strategies in cell and tissue engineering and the design of cardiovascular prosthetic devices.

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Lower extremity arterial reconstruction in the very elderly: Successful outcome preserves not only the limb but also residential status and ambulatory function

Abstract: LEAR in octogenarians is safe, with graft patency and limb salvage rates comparable to those reported for younger patients. LEAR preserves the ability to ambulate and reside at home for most patients.

Cited by 106 publications

References 26 publications

Bacterial cellulose as a potential vascular graft: Mechanical characterization and constitutive model development

Bacterial cellulose as a potential vascular graft: Mechanical characterization and constitutive model development

Cellular engineering of vascular bypass grafts: Role of chemical coatings for enhancing endothelial cell attachment

Characterization of Endothelial Basement Membrane Nanotopography in Rhesus Macaque as a Guide for Vessel Tissue Engineering

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