Clinical in vitro endothelialization of femoropopliteal bypass grafts: An actuarial follow-up over three years

Zilla, Peter; Deutsch, Manfred; Meinhart, Johann; Puschmann, Rudolf; Eberl, Thomas; Minar, Erich; Dudczak, Robert; Lugmaier, Herbert; Schmidt, Peter Koerver; Noszian, Irene; Fischlein, T

doi:10.1016/s0741-5214(94)70083-4

Cited by 201 publications

(106 citation statements)

References 24 publications

(5 reference statements)

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“…However, 30-40% of patients requiring small vessel reconstruction (<5 mm in diameter) have either no or inadequate saphenous veins [209]. Because small caliber artificial vascular grafts currently available occlude within a short period of time, new approaches have been adopted to improve their biocompatibility, such as transplanting a monolayer of endothelial cells onto the luminal surface of a graft prior to implantation [210][211][212] and tissue engineering [213,214]. Biodegradable polymers such as poly(L-lactic acid) (PLLA), poly(glycolic acid) (PGA) and PGA coated with PLLA are employed in cell transplantation and in vivo regeneration of vascular tissue.…”

Section: Other Polymersmentioning

confidence: 99%

Plasma-surface modification of biomaterials

Chu

Chen

Wang

et al. 2002

Materials Science and Engineering: R: Reports

1,406

652

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Plasma-surface modification (PSM) is an effective and economical surface treatment technique for many materials and of growing interests in biomedical engineering. This article reviews the various common plasma techniques and experimental methods as applied to biomedical materials research, such as plasma sputtering and etching, plasma implantation, plasma deposition, plasma polymerization, laser plasma deposition, plasma spraying, and so on. The unique advantage of plasma modification is that the surface properties and biocompatibility can be enhanced selectively while the bulk attributes of the materials remain unchanged. Existing materials can, thus, be used and needs for new classes of materials may be obviated thereby shortening the time to develop novel and better biomedical devices. Recent work has spurred a number of very interesting applications in the biomedical field. This review article concentrates upon the current status of these techniques, new applications, and achievements pertaining to biomedical materials research. Examples described include hard tissue replacements, blood contacting prostheses, ophthalmic devices, and other products. #

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Section: Other Polymersmentioning

confidence: 99%

Plasma-surface modification of biomaterials

Chu

Chen

Wang

et al. 2002

Materials Science and Engineering: R: Reports

1,406

652

View full text Add to dashboard Cite

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“…After in vitro shear stress-testing and preclinical primate studies, we eventually commenced clinical trials with in vitro endothelialized femoro-popliteal bypass grafts in 1989 (Zilla et al, 1994;Meinhart et al, 1997;Deutsch et al, 1997;Magometschnigg et al, 1992). To date, four different groups have reported their experience with clinical in vitro endothelialization with a follow-up period of up to 11 years.…”

Section: Clinical In Vitro Endothelializationmentioning

confidence: 99%

“…The longest and most extensive study performed by our own group comprises almost 180 in vitro endothelialized ePTFE grafts and is still ongoing. Phase 1 of this study was a randomised trial comparing untreated ePTFE grafts with endothelialized ones (Zilla et al, 1994). Forty-nine patients entered this initial study between June 1989 and December 1991.…”

Section: Clinical In Vitro Endothelializationmentioning

confidence: 99%

Engineering of vascular ingrowth matrices: Are protein domains an alternative to peptides?

2001

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Anastomotic intimal hyperplasia and surface thrombogenicity are the main reasons for the high failure rate of prosthetic small-diameter vascular grafts. While anastomotic intimal hyperplasia is a multifactorial event, ongoing surface thrombogenicity is primarily caused by the lack of an endothelium, even after years of clinical implantation. After decades of poorly performing synthetic artery-grafts, tissue engineering has emerged as a promising approach to generate biologically functional bio-synthetic hybrid grafts mimicking native arteries regarding the presence of an endothelial lining on the blood surface. "In vitro endothelialization" represented the first generation of such tissue-engineered vascular grafts, utilising cell culture techniques for the creation of a confluent autologous endothelium on ePTFE grafts. The clinical long-term results with this method in almost 200 patients are highly encouraging, showing patencies equal to vein grafts. Since "in vitro endothelialization" requires cell culture facilities, it will always be confined to large centres. Therefore, research of the 1990s turned to the development of spontaneously endothelializing implants, to make tissue-engineered grafts amenable to the entire vascular-surgical community. Apart from scaffold designs allowing transmural ingrowth, biological signalling through a facilitating ingrowth matrix holds a key to spontaneous endothelialization. In biological signalling, the increasingly deeper understanding of bio-active molecules and the discovery of domains and peptide sequences during the 1980s created the expectation in the 1990s that peptide signalling may be all that is needed. This present review highlights the possible problems associated with such a reductionist approach. Using the fibronectin molecule, we demonstrated that domains may be more suitable modules in tissue engineering than peptide sequences.

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“…The lack of a confluent endothelial lining is repeatedly cited as the most common cause of conduit failure [2,3]. In vitro graft endothelialisation is an emerging method, which has been shown in several long-term human clinical trials to significantly enhance the patency rates of small caliber synthetic grafts [4][5][6][7]. In this technique, autologous endothelial cells (ECs) are harvested from superficial veins or adipose tissue and seeded onto the graft lumen prior to implantation.…”

Section: Introductionmentioning

confidence: 99%