Optimization of rifampin coating on covered Dacron endovascular stent grafts for infected aortic aneurysms

Abstract

Having studied two variables of rifampin coating techniques to Dacron ESGs, the authors propose a rapid real-time perioperative coating protocol by using a 10-mg/mL rifampin solution for a 10-minute incubation period. As rifampin loosely binds to Dacron ESGs by weak intermolecular forces, a rifampin-coated ESG would need to be inserted in a timely fashion to treat the diseased aorta and to deliver its antibiotic affect. A rapid perioperative coating protocol followed by immediate deployment makes our proposed technique especially useful in an urgent and unstable clinical scenario.

Thrombogenic and Inflammatory Reactions to Biomaterials in Medical Devices

“…Although surgical revascularization using non-biodegradable polymer devices made of polytetrafluoroethylene, Gore-tex, and polyester (Dacron) has shown to be effective in replacing large-diameter vessels, when used as small-diameter vascular grafts, they were commonly complicated by thrombotic occlusions (Roll et al, 2008). No clear advantage of one over the other has been shown among polytetrafluoroethylene and Dacron prosthetic materials for peripheral vascular surgery (Roll et al, 2008), although it has been proposed that antibiotic impregnated Dacron endovascular stent grafts could be used for aneurysm repair, a technique particularly useful under urgent and unstable clinical situations (Hennessey et al, 2019). All these synthetic materials are limited by their lack of hemocompatibility that can lead to severe inflammation and thrombosis associated with the occlusion of the stents.…”

Management of Vascular Graft Infection

“…For example, vascular grafts with immobilised VEGF and anti-CD34 show improved endothelialisation in vitro and in mice inferior vena cava 15 ; this opens up the possibility of having other factors to modulate the inflammatory reaction to graft insertion, and perhaps locally hinder atherosclerosis. Coating grafts with antibiotics such as vancomycin and rifampicin has been shown to elute high concentrations in vitro and in rabbits in vivo 16,17 . However, it is still uncertain how flow and the surface of the aneurysmal sac will affect the local concentrations of the antibiotic, and what concentration of antibiotic coating is required to provide sufficient time and concentration for infection control.…”

An innovative method to obtain porous porcine aorta scaffolds for tissue engineering

“…Many of these conditions require surgical interventions to replace or enhance damaged vessels using vascular substitutes. Currently, synthetic biomaterials, such as Dacron (polyethylene terephthalate) and ePTFE (expanded polytetrafluoroethylene) have been widely used in vascular surgery . These biomaterials possess good mechanical properties and durability in vivo.…”

“…Currently, synthetic biomaterials, such as Dacron (polyethylene terephthalate) and ePTFE (expanded polytetrafluoroethylene) have been widely used in vascular surgery. [3][4][5] These biomaterials possess good mechanical properties and durability in vivo. However, a major drawback of them is a compliance mismatch with the native artery, which may lead to potential graft failure and major morbidity.…”