The Impact of Stent Graft Material on the Inflammatory Response After EVAR

Sartipy, Fredrik; Lindström, David; Gillgren, Peter; Ternhag, Anders

doi:10.1177/1538574415595209

Cited by 27 publications

(25 citation statements)

References 12 publications

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“…Polytetrafluoroethylene (PTFE) is commonly used for making various cardiovascular implants and medical devices such as vascular bypass grafts, balloon catheters, and heart patches . Also, PTFE is used for making some of the principal components of heart valves and stent grafts . Although PTFE has such widespread clinical applications, the implants that are made from this material are still associated with undesirable clinical events such as anastomotic neointimal hyperplasia and acute thrombosis .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Also, PTFE is used for making some of the principal components of heart valves and stent grafts. 4,5 Although PTFE has such widespread clinical applications, the implants that are made from this material are still associated with undesirable clinical events such as anastomotic neointimal hyperplasia and acute thrombosis. 1,5,6 These events are primarily caused due to inappropriate interactions of endothelial cells (ECs), smooth muscle cells (SMCs), and platelets with PTFE.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Although PTFE has such widespread clinical applications, the implants that are made from this material are still associated with undesirable clinical events such as anastomotic neointimal hyperplasia and acute thrombosis. 1,5,6 These events are primarily caused due to inappropriate interactions of endothelial cells (ECs), smooth muscle cells (SMCs), and platelets with PTFE. 1,5,6 The polymer PTFE is one of the most commonly used biomaterials for making vascular grafts and prosthesis due to its suitable mechanical properties and excellent biostability.…”

Section: Introductionmentioning

confidence: 99%

“…1,5,6 These events are primarily caused due to inappropriate interactions of endothelial cells (ECs), smooth muscle cells (SMCs), and platelets with PTFE. 1,5,6 The polymer PTFE is one of the most commonly used biomaterials for making vascular grafts and prosthesis due to its suitable mechanical properties and excellent biostability. 7 However, PTFE is a poor substrate for cell adhesion and growth due to its strong hydrophobicity.…”

Section: Introductionmentioning

confidence: 99%

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Responses of endothelial cells, smooth muscle cells, and platelets dependent on the surface topography of polytetrafluoroethylene

Lamichhane

Anderson

Remund

et al. 2016

J Biomedical Materials Res

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In this study, the effect of different structures (flat, expanded, and electrospun) of polytetrafluoroethylene (PTFE) on the interactions of endothelial cells (ECs), smooth muscle cells (SMCs), and platelets was investigated. In addition, the mechanisms that govern the interactions between ECs, SMCs, and platelets with different structures of PTFE were discussed. The surface characterizations showed that the different structures of PTFE have the same surface chemistry, similar surface wettability and zeta potential, but uniquely different surface topography. The viability, proliferation, morphology, and phenotype of ECs and SMCs interacted with different structures of PTFE were investigated. Expanded PTFE (ePTFE) provided a relatively better surface for the growth of ECs. In case of SMC interactions, although all the different structures of PTFE inhibited SMC growth, a maximum inhibitory effect was observed for ePTFE. In case of platelet interactions, the electrospun PTFE provided a better surface for preventing the adhesion and activation of platelets. Thus, this study demonstrated that the responses of ECs, SMCs, and platelets strongly dependent on the surface topography of the PTFE. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2291-2304, 2016.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Responses of endothelial cells, smooth muscle cells, and platelets dependent on the surface topography of polytetrafluoroethylene

Lamichhane

Anderson

Remund

et al. 2016

J Biomedical Materials Res

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“…An important finding regarding the systemic inflammatory response was that post-operative hs-CRP levels were highly associated with cardiovascular events in the 30-day post-operative period. Synthetic polyester, used as graft material (as opposed to PTFE), appears to produce a greater inflammatory response, and may be an independent predictor of post-implantation syndrome [66,67]. Further study needs to be done to determine whether these findings should influence choice of graft.…”

Section: Other Post-operative Complicationsmentioning

confidence: 92%

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

O’Mara

Bersin

2016

Curr Treat Options Cardio Med

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Endovascular aneurysm repair (EVAR) has become the predominant method of treatment for abdominal aortic aneurysms (AAA). The use of conscious sedation with local anesthesia and percutaneous femoral access has further decreased the morbidity of the procedure. Current devices can more effectively manage increasingly "hostile" aneurysm necks, while chimney grafts or dedicated fenestrated stent-grafts can be used for juxta-renal disease with favorable results. However, endovascular repair does present a new set of challenges, and endoleaks remain an area of concern. While there is general consensus that type I and type III endoleaks require treatment, type II endoleaks are the topic of ongoing research and debate. Development of devices and techniques to prevent and treat endoleak continues to progress. Advances in contrast-enhanced ultrasound are reducing reliance on computed tomography for post-operative monitoring. This is an important step in this population at high risk for the development of kidney failure. Despite these many innovations, further research is needed to optimize the care of patients with AAA.

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Polytetrafluoroethylene topographies determine the adhesion, activation, and foreign body giant cell formation of macrophages

Lamichhane

Anderson

Vierhout

et al. 2017

J Biomedical Materials Res

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Polytetrafluoroethylene (PTFE) is one of the commonly used materials in making various cardiovascular implants. However, the success rates of these implants in several occasions are hindered by unwanted immune responses from immune cells, such as macrophages. In this study, we investigated the response of macrophages with different structures (flat, expanded, and electrospun) of PTFE having varied surface topographies: smooth planar surface (flat PTFE), node-fibrils (ePTFE), and randomly oriented microfibers (electrospun PTFE). The electrospun PTFE showed the least adhesion of macrophages. Also, the morphology of macrophages adhered on electrospun PTFE exhibited minimal activation. The macrophage pro-inflammatory cytokine secretions showed that the lowest level of TNF-α was produced on electrospun PTFE whereas IP-10 was produced in lowest levels on expanded PTFE (ePTFE). The production of IL-6 and MCP-1 cytokines was also dependent on the structure of PTFE that the macrophages interacted with, but in a time-dependent manner. Confocal microscopy images taken at 7, 14, and 21 days showed that the electrospun PTFE resulted in the lowest percentage of macrophage fusion, thus indicating the least possible chance of foreign body giant cell (FBGC) formation. Therefore, this study showed that electrospun PTFE with randomly oriented microfibers can provide reduced adhesion, activation, and FBGC formation of macrophages compared to the smooth and planar surface of flat PTFE and node-fibril structured surface of ePTFE. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2441-2450, 2017.

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The Impact of Stent Graft Material on the Inflammatory Response After EVAR

Abstract: Standard EVAR with polyester stent grafts appears to result in a trend toward a more pronounced inflammatory reaction than similar EVAR using PTFE and is associated with a longer in-hospital stay.

Cited by 27 publications

References 12 publications

Responses of endothelial cells, smooth muscle cells, and platelets dependent on the surface topography of polytetrafluoroethylene

Responses of endothelial cells, smooth muscle cells, and platelets dependent on the surface topography of polytetrafluoroethylene

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

Polytetrafluoroethylene topographies determine the adhesion, activation, and foreign body giant cell formation of macrophages

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