Collagen External Scaffolds Mitigate Intimal Hyperplasia and Improve Remodeling of Vein Grafts in a Rabbit Arteriovenous Graft Model

Abstract

Objectives. The aim of this study was to test the effects of collagen external scaffold (CES) in intimal hyperplasia of vein grafts and explore its underlying mechanisms. Methods. Thirty-six New Zealand white rabbits were randomized into no-graft group, graft group, and CES group. The rabbit arteriovenous graft model was established. In CES group, the vein graft was wrapped around with CES. The hemodynamic parameters of vein grafts were measured intraoperatively and 4 weeks after operation by ultrasonic examination. Histological characteristics of vein grafts were also evaluated 4 weeks later. The mRNA and protein levels of proliferating cell nuclear antigen (PCNA), active cleaved-caspase-3 (ClvCasp-3), and smooth muscle 22 alpha (SM22α) were measured 4 weeks later by quantitative real-time PCR and western blot. Results. CES significantly improved the hemodynamic stability of vein grafts, with higher blood velocity and blood flow. Similarly, CES also markedly mitigated intimal hyperplasia and inhibited dilatation of vein grafts. In CES group, the upexpression of PCNA and ClvCasp-3 and the downexpression of SM22α were inhibited. Conclusion. CES exerts beneficial effects in mitigating intimal hyperplasia and improving remodeling of autogenous vein grafts, which may be associated with reducing the proliferation and apoptosis and preserving the phenotype of VSMCs.

The main trunk of RCA may be the best choice of sequential vein graft distal end-to-side anastomosis

“…25 In our previous studies, we found that higher blood flow could improve the hemodynamic stability of vein grafts, and the specific mechanism may be that it could mitigate intimal hyperplasia and improve remodeling of venous grafts, which may be associated with reducing the proliferation and apoptosis and preserving the phenotype of vascular smooth muscle cell. 26 In our study, we also found that the higher the blood flow, the higher the patency. The blood flow of LAD was the highest in the target vessels, and its patency was more than 90%, especially the patency of LIMA-LAD was as high as 96.11%.…”

Functioning tailor-made 3D-printed vascular graft for hemodialysis

“…[25][26][27][28][29][30][31] Only an autologous venous graft model in rabbits has been reported, in which an excised external jugular vein graft was anastomosed to replace a removed segment of the ipsilateral common carotid artery in an end-to-end manner. 32,33 Therefore, our 3D-printed AVG should be examined for a long-term patency rate using the large animal model.…”

The Effects of Pro-Inflammatory and Anti-Inflammatory Agents for the Suppression of Intimal Hyperplasia: An Evidence-Based Review

“…Inflammation within the vascular wall is a hurdle, and manipulating the inflammatory cytokines and chemokines is possibly the key piece in solving the puzzle. Other than that, research related to inhibition of intimal hyperplasia has also been extensively done using various approaches, which utilized gene therapy and vector-mediated gene delivery [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ], anti-inflammatory and anti-proliferative drugs [ 57 ], compounds with anti-inflammatory actions such as plants [ 55 , 65 ], herbal medications [ 50 ], marine sources [ 52 ] and polyunsaturated fatty acids [ 56 ].…”