Suppression of neointimal hyperplasia by sirolimus-eluting expanded polytetrafluoroethylene (ePTFE) haemodialysis grafts in comparison with paclitaxel-coated grafts

Abstract

Neointimal hyperplasia was effectively suppressed by sirolimus-eluting grafts. However, the inhibitory effects of sirolimus-eluting grafts were weaker than those observed for paclitaxel-coated grafts in our previous study.

Dual biofunctional polymer modifications to address endothelialization and smooth muscle cell integration of ePTFE vascular grafts

“…While it has been shown that ECs play a significant role in SMC regulation, few of the studies addressing endothelialization go one step further to also directly address intimal hyperplasia . Research to inhibit intimal hyperplasia directly in ePTFE grafts has mostly been limited to physical manufacturing alterations such as the addition of anastomotic cuffs, or delivery of antiproliferative drugs such as paclitaxel to inhibit SMC proliferation, but neither of these approaches specifically encourage endothelialization . Our group has previously demonstrated that FSP modification of ePTFE surfaces can be used to introduce EC‐selective ligands for cell attachment that simultaneously resist platelet deposition .…”

“…28 Research to inhibit intimal hyperplasia directly in ePTFE grafts has mostly been limited to physical manufacturing alterations such as the addition of anastomotic cuffs, or delivery of antiproliferative drugs such as paclitaxel to inhibit SMC proliferation, but neither of these approaches specifically encourage endothelialization. 16,29 Our group has previously demonstrated that FSP modification of ePTFE surfaces can be used to introduce EC-selective ligands for cell attachment that simultaneously resist platelet deposition. 17,18 In addition, we have shown that extracellular matrix-mimetic PEG-based hydrogels are a promising scaffold to modulate SMC proliferation, migration, and phenotype.…”

“…Common strategies to inhibit IH revolve around local delivery of antimitogenic drugs such as sirolimus or paclitaxel to the target area. ePTFE grafts coated with both drugs have shown reduced IH in a porcine model; however, this strategy is limited to the duration of drug presence and the studies performed have not examined the extent of IH in the long term (>6 weeks) or the safety of drug delivery . A strategy that promotes contractile SMC healing within the graft while limiting SMC proliferation could result in a construct that is more sustainable for long term.…”

Cutting-Edge Regenerative Medicine Technologies for the Treatment of Heart Valve Calcification

“…Limus derivatives are a large family of compounds preventing either allograft rejections or restenosis after angioplasty. Conversely, systemic toxic effects, unspecific antiproliferation activity on ECs and SMCs, and variable efficacy associated with their usage in vitro or in vivo are at the basis of the reported controversial results [199][200][201][202][203].…”

Back to the Future: How Biology and Technology Could Change the Role of PTFE Grafts in Vascular Access Management

“…Sirolimus and Paclitaxel‐Eluting Grafts. A number of publications have documented that dip coating PTFE grafts with either paclitaxel (72) or sirolimus (73) (both antiproliferative agents) reduces neointimal hyperplasia and improves patency. Initial results suggest that the magnitude of neointimal hyperplasia reduction appears to be greater with paclitaxel than with sirolimus.…”