The incomplete endothelialization of especially small-caliber vascular prostheses after implantation in patients is a major disadvantage in cardiovascular interventions. The lack of an endothelium leads to the occurrence of thrombosis at the luminal surface of artificial vascular prostheses. Thus, the development of new graft materials and coatings for induction of complete endothelialization on the implant surfaces is a promising approach to improve hemocompatibility and maintain long-term graft patency. In this study, we designed a rotation model to evaluate the early endothelial cell (EC) seeding efficiency of different small-caliber vascular devices, such as stents and vascular grafts. The suitability of the designed rotation model for endothelialization studies was investigated by seeding and cultivation of prostheses with ECs followed by scanning electron microscopy. Furthermore, the viability of attached ECs was determined by calcein acetoxymethyl ester (AM) staining. The rotation model consisting of low-cost medical disposables enabled sterile incubation and cultivation of ECs with vascular devices. Simultaneously, the rotation of the bioreactor ensured a uniform distribution and adhesion of cells to the devices. Calcein AM staining of adherent cells on prostheses revealed excellent cell viability. Moreover, using the designed rotation model, an influence of different coatings and materials on the adhesion and spreading of ECs was demonstrated. The rotating bioreactor described and used in this study not only saves time and money but is also eminently useful for the accelerated preclinical evaluation of the endothelialization efficiency of different materials and surface coatings of small-caliber vascular devices.
Interventional therapies using angioplasty and stenting of symptomatic stenosis of the proximal supraaortic vessels have evolved as safe and effective treatment strategies. The aim of this paper is to summarize the current treatment concepts for stenosis in the subclavian and brachiocephalic artery with regard to clinical indication, interventional technique including selection of the appropriate vascular approach and type of stent, angiographic and clinical short-term and long-term results and follow-up. The role of hybrid interventions for tandem stenoses of the carotid bifurcation and brachiocephalic artery is analysed. A systematic review of data for angioplasty and stenting of symptomatic extracranial vertebral artery stenosis is discussed with a special focus on restenosis rate.
We report a case of a 43-year-old woman, who presented with thoracic interscapular pain at a peripheral hospital. In addition, the patient reported retrosternal pain, which had occurred only hours before-after an upsetting telephone call. The CT imaging ruled out an aortic dissection but revealed a huge sinus valsalva aneurysm (SVA) while the laboratory parameters showed slightly elevated troponin T value. Echocardiography showed an akinesia of the midventricular and apical left ventricular wall, accompanied by normal basal contractility. Stenotic coronary disease and endomyocarditis could be excluded as the origin of the contractility disorders. The synopsis of the findings and patient's medical history led to the assumption of the takotsubo cardiomyopathy triggered by stress due to the worrying telephone call and the pain originating from the symptomatic SVA. We decided to perform an elective operation of the symptomatic aneurysm after restitution of the ejection fraction--as expected in takotsubo cardiomyopathy--instead of an emergency operation.
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