An integrated strategy for designing and fabricating triple-layer vascular graft with oriented microgrooves to promote endothelialization

Chen, Xiao; Yao, Yuan; Liu, Suihong; Hu, Qingxi

doi:10.1177/08853282211001006

Cited by 11 publications

(7 citation statements)

References 43 publications

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“…Open surgical approaches might be preferred to patients with MFS mainly because of the complex and extensive involvement of the aorta (with the chance of also requiring intervention of the aortic valve), the increased risk for endoleaks and endoprosthesis migration, and the young age of the patients that may face a lifetime risk of aortic complications (15). However, endovascular and hybrid approaches have been reported in the literature (13,14,(20)(21)(22). In our case series, 88% of the procedures were performed with open approaches.…”

Section: Discussionmentioning

confidence: 99%

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Challenges in Prompt Identification and Surgical Correction of Marfan Syndrome Aortic Disease in a middle-income Country: A Case Series Study.

Velandia-Sánchez,

Polanía-Sandoval,

Senosiain-González

et al. 2023

Preprint

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Background: Marfan Syndrome is an autosomal dominant disease caused by pathogenetic variants in the FBN1 gene. The progressive dilatation of the aorta and the potential risk of acute aortic syndromes influence the prognosis of these patients. We aim to describe population characteristics, long-term survival, and re-intervention patterns in patients who underwent aortic surgery with a previously confirmed clinical diagnosis of Marfan Syndrome in a middle-income country. Methods: A retrospective single-center case series study was conducted. All Marfan Syndrome patients who underwent aortic procedures from 2004 until 2021 were included. Qualitative variables were frequency-presented, while quantitative ones adopted mean ± standard deviation. A subgroup analysis between elective and emergent procedures was conducted. Kaplan-Meier plots depicted cumulative survival and re-intervention-free. Control appointments and government data tracked out-of-hospital mortality. Results: 50 patients were identified. Mean age was 38.79 ± 14.41 years, with a male-to-female ratio of 2:1. Common comorbidities included aortic valve regurgitation (66%) and hypertension (50%). Aortic aneurysms were observed in 64% without dissection and 36% with dissection. Surgical procedures comprised elective (52%) and emergent cases (48%). The most common surgery performed was valve-sparing root replacement, specifically the David procedure (64%), and the Bentall procedure (14%). The in-hospital mortality rate was 4%. Complications included stroke (10%), and acute kidney injury (6%). The average follow-up was 8.88 ± 5.78 years. Survival rates at 5, 10, and 15 years were 89%, 73%, and 68%, respectively. Reintervention rates at 1, 2.5, and 5 years were 10%, 14%, and 17%, respectively. The emergent subgroup was younger (37.58 ± 14.49 years), had the largest number of Stanford A aortic dissections, presented hemodynamic instability (41.67%), and had a higher requirement of reinterventions in the first 5 years of follow-up (p=0.030). Conclusion: In our study, surveillance programs played a pivotal role in sustaining high survival rates and identifying re-intervention requirements. However, challenges persist, as 48% of the patients required emergent surgery. Despite not affecting survival rates, a greater requirement for reinterventions was observed, emphasizing the necessity of timely diagnosis. Enhanced educational initiatives for healthcare providers and increased patient involvement in follow-up programs are imperative to address these concerns.

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Section: Discussionmentioning

confidence: 99%

“…Also, FET has shown that in patients with MFS and type A aortic dissection can effectively reduce the false lumen and stabilize the distal aorta (22).…”

Section: Discussionmentioning

confidence: 99%

Challenges in Prompt Identification and Surgical Correction of Marfan Syndrome Aortic Disease in a middle-income Country: A Case Series Study.

Velandia-Sánchez,

Polanía-Sandoval,

Senosiain-González

et al. 2023

Preprint

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“…53,54 The multi-layer structure of the vascular implant uses the directional microgrooves between the biomimetic layers to promote the directional growth and migration of ECs, and better mimic the arrangement of natural vascular cells. 55 Vascular implant materials containing microchannel structures both highly interconnected and circumferentially oriented can not only effectively affect the morphology, arrangement, and phenotypic changes of SMCs, but also improve the directional deposition of ECM on the surface of the material and the enrichment and polarization of macrophages, promote cell infiltration and accelerate the process of endothelialization. 56 By manipulating the micro-nano scale morphology of the material surface, the anchoring of MSCs membrane protein can be effectively regulated, and the process of differentiation into SMCs can be induced by the traction of F-actin, which is further used for the repair of vascular microenvironment.…”

Section: Surface Microstructurementioning

confidence: 99%

Endothelialization strategy of implant materials surface: The newest research in recent 5 years

Bian

Chen

Weng

et al. 2022

Journal of Applied Biomaterials & Functional Materials

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In recent years, more and more metal or non-metal materials have been used in the treatment of cardiovascular diseases, but the vascular complications after transplantation are still the main factors restricting the clinical application of most grafts, such as acute thrombosis and graft restenosis. Implant materials have been extensively designed and surface optimized by researchers, but it is still too difficult to avoid complications. Natural vascular endodermis has excellent function, anti-coagulant and anti-intimal hyperplasia, and it is also the key to maintaining the homeostasis of normal vascular microenvironment. Therefore, how to promote the adhesion of endothelial cells (ECs) on the surface of cardiovascular materials to achieve endothelialization of the surface is the key to overcoming the complications after implant materialization. At present, the surface endothelialization design of materials based on materials surface science, bioactive molecules, and biological function intervention and feedback has attracted much attention. In this review, we summarize the related research on the surface modification of materials by endothelialization in recent years, and analyze the advantages and challenges of current endothelialization design ideas, explain the relationship between materials, cells, and vascular remodeling in order to find a more ideal endothelialization surface modification strategy for future researchers to meet the requirements of clinical biocompatibility of cardiovascular materials.

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“…Analyzing the live-to-dead cell ratio revealed a percentage below 10% for samples containing up to 20 wt % MXene (Figure 5b). However, as the concentration of MXene in the To inhibit acute thrombosis and the migration of smooth muscle cells into the intima, a vascular prosthesis should promote rapid reendothelialization; 28 for this reason the rate of cell proliferation in the samples was studied (Figure 5c). The highest cell growth rate after 3 and 7 days was noticed on the 0 wt % MXene sample with glycerol, which mirrored the trends from the live/dead cell assay where the largest cell population was seen on the same sample.…”

Section: ■ Introductionmentioning

confidence: 99%

PMMA/PDMS/MXene Nanofibers for Postsurgery Monitoring of Vascular Implants

Zizhou,

Baratchi,

Khoshmanesh

et al. 2024

ACS Appl. Nano Mater.

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Continuous monitoring of implanted vascular implants poses challenges due to the inherent toxicity and instability of contrast agents within the body. The use of biocompatible materials with radiopaque properties offers a solution for continuous monitoring of implanted artificial grafts together with early detection of vascular prosthesis dysfunction, which mitigates the risk of catastrophic failures from leakages or aneurysms. Here, we aimed to develop an artificial vascular graft with enhanced radiopacity to facilitate postsurgery monitoring. To achieve this goal, MXene (Ti 3 C 2 nanosheets) was incorporated into poly(methyl methacrylate) (PMMA)/polydimethylsiloxane (PDMS) nanofibers via an electrospinning technique, to enhance radiopacity without compromising biocompatibility. The integration of MXene into the nanofiber resulted in an increase in the hydrophilicity of the samples, leading to enhanced cell attachment. Microcomputed tomography imaging was used to verify the radiopacity properties of the samples, showing excellent contrast characteristics. The biocompatibility and hemocompatibility of the samples showed that 50 wt % MXene is the optimal concentration, demonstrating no cytotoxic effects. This is due to the encapsulation of MXene inside the PMMA/PDMS nanofibers preventing the interaction of MXene nanosheets with the physiological environment in vitro while maintaining their radiopacity. This approach herein holds promise as a platform for the long-term monitoring of implanted polymeric materials, thereby addressing a critical unmet need in the field.

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An integrated strategy for designing and fabricating triple-layer vascular graft with oriented microgrooves to promote endothelialization

Cited by 11 publications

References 43 publications

Challenges in Prompt Identification and Surgical Correction of Marfan Syndrome Aortic Disease in a middle-income Country: A Case Series Study.

Challenges in Prompt Identification and Surgical Correction of Marfan Syndrome Aortic Disease in a middle-income Country: A Case Series Study.

Endothelialization strategy of implant materials surface: The newest research in recent 5 years

PMMA/PDMS/MXene Nanofibers for Postsurgery Monitoring of Vascular Implants

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