Large animal model of vein grafts intimal hyperplasia: A systematic review

Fashina, Oluwatomini; Abbasciano, Riccardo; McQueen, Liam W.; Ladak, Shameem; George, Sarah J.; Suleiman, Sadeeh; Punjabi, Prakash P; Angelini, Gianni; Zakkar, Mustafa

doi:10.1177/02676591221091200

Cited by 6 publications

(4 citation statements)

References 118 publications

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“…A recent systematic review (2023) on large animal models of vein graft hyperplasia [ 8 ] identified five studies that utilized porcine internal jugular veins as vascular graft in carotid arteries [ 29 , 30 , 31 , 32 , 33 ]. Additionally, we have found one more [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

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External Support of Autologous Internal Jugular Vein Grafts with FRAME Mesh in a Porcine Carotid Artery Model

Chlupac,

Frank,

Sedmera

et al. 2024

Biomedicines

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Background: Autologous vein grafts are widely used for bypass procedures in cardiovascular surgery. However, these grafts are susceptible to failure due to vein graft disease. Our study aimed to evaluate the impact of the latest-generation FRAME external support on vein graft remodeling in a preclinical model. Methods: We performed autologous internal jugular vein interposition grafting in porcine carotid arteries for one month. Four grafts were supported with a FRAME mesh, while seven unsupported grafts served as controls. The conduits were examined through flowmetry, angiography, macroscopy, and microscopy. Results: The one-month patency rate of FRAME-supported grafts was 100% (4/4), whereas that of unsupported controls was 43% (3/7, Log-rank p = 0.071). On explant angiography, FRAME grafts exhibited significantly more areas with no or mild stenosis (9/12) compared to control grafts (3/21, p = 0.0009). Blood flow at explantation was higher in the FRAME grafts (145 ± 51 mL/min) than in the controls (46 ± 85 mL/min, p = 0.066). Area and thickness of neo-intimal hyperplasia (NIH) at proximal anastomoses were similar for the FRAME and the control groups: 5.79 ± 1.38 versus 6.94 ± 1.10 mm2, respectively (p = 0.558) and 480 ± 95 vs. 587 ± 52 μm2/μm, respectively (p = 0.401). However, in the midgraft portions, the NIH area and thickness were significantly lower in the FRAME group than in the control group: 3.73 ± 0.64 vs. 6.27 ± 0.64 mm2, respectively (p = 0.022) and 258 ± 49 vs. 518 ± 36 μm2/μm, respectively (p = 0.0002). Conclusions: In our porcine model, the external mesh FRAME improved the patency of vein-to-carotid artery grafts and protected them from stenosis, particularly in the mid regions. The midgraft neo-intimal hyperplasia was two-fold thinner in the meshed grafts than in the controls.

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Section: Discussionmentioning

confidence: 99%

“…External stenting has shown considerable promise in preclinical [3,8] and, to some extent, in clinical studies [9,10] (for a review, see [6,11,12]). Most clinical trials have been conducted on CABG surgery [13]; however, reports on PABG surgery are limited [14,15].…”

Section: Introductionmentioning

confidence: 99%

External Support of Autologous Internal Jugular Vein Grafts with FRAME Mesh in a Porcine Carotid Artery Model

Chlupac,

Frank,

Sedmera

et al. 2024

Biomedicines

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“…Over the years, many attempts been made to modulate IH with limited success of any single strategy [29]. Veins in situ of the coronary circulation are known to experience different haemodynamics to arteries, and once a vein is implanted into the arterial circulation it is suddenly exposed to new forces such as changes in shear stress and increased flow and pressure which activates ECs and triggers an inflammatory process [8][9][10]30].…”

Section: Discussionmentioning

confidence: 99%

Osteopontin Activation and Microcalcification in Venous Grafts Can Be Modulated by Dexamethasone

McQueen,

Ladak,

Layton

et al. 2023

Cells

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Background: Osteopontin has been implicated in vascular calcification formation and vein graft intimal hyperplasia, and its expression can be triggered by pro-inflammatory activation of cells. The role of osteopontin and the temporal formation of microcalcification in vein grafts is poorly understood with a lack of understanding of the interaction between haemodynamic changes and the activation of osteopontin. Methods: We used a porcine model of vein interposition grafts, and human long saphenous veins exposed to ex vivo perfusion, to study the activation of osteopontin using polymerase chain reaction, immunostaining, and 18F-sodium fluoride autoradiography. Results: The porcine model showed that osteopontin is active in grafts within 1 week following surgery and demonstrated the presence of microcalcification. A brief pretreatment of long saphenous veins with dexamethasone can suppress osteopontin activation. Prolonged culture of veins after exposure to acute arterial haemodynamics resulted in the formation of microcalcification but this was suppressed by pretreatment with dexamethasone. 18F-sodium fluoride uptake was significantly increased as early as 1 week in both models, and the pretreatment of long saphenous veins with dexamethasone was able to abolish its uptake. Conclusions: Osteopontin is activated in vein grafts and is associated with microcalcification formation. A brief pretreatment of veins ex vivo with dexamethasone can suppress its activation and associated microcalcification.

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“…This process, now commonly referred to as neointimal hyperplasia (NIH), is recognized as a contributing factor to the stenosis events leading to complications and failures in interventions that involve venous conduits, such as coronary artery bypass grafting, coronary angioplasty, lower limb vein bypass, peripheral artery angioplasty, carotid endarterectomy, and arteriovenous fistula (AVF) or artificial graft for hemodialysis. The complex etiology and pathophysiology of NIH have been progressively unraveled through years of many physician-scientists' research, and excellently presented in several successive landmark reviews (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In essence, the triggering event in the development of NIH is an injury to the vascular endothelium generated by turbulent vasculature hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic strategies based on non-ionizing radiation to prevent venous neointimal hyperplasia: the relevance for stenosed arteriovenous fistula, and the role of vascular compliance

Russu,

Arbanasi,

Chirila

et al. 2024

Front. Cardiovasc. Med.

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We have reviewed the development and current status of therapies based on exposure to non-ionizing radiation (with a photon energy less than 10 eV) aimed at suppressing the venous neointimal hyperplasia, and consequentially at avoiding stenosis in arteriovenous grafts. Due to the drawbacks associated with the medical use of ionizing radiation, prominently the radiation-induced cardiovascular disease, the availability of procedures using non-ionizing radiation is becoming a noteworthy objective for the current research. Further, the focus of the review was the use of such procedures for improving the vascular access function and assuring the clinical success of arteriovenous fistulae in hemodialysis patients. Following a brief discussion of the physical principles underlying radiotherapy, the current methods based on non-ionizing radiation, either in use or under development, were described in detail. There are currently five such techniques, including photodynamic therapy (PDT), far-infrared therapy, photochemical tissue passivation (PTP), Alucent vascular scaffolding, and adventitial photocrosslinking. The last three are contingent on the mechanical stiffening achievable by the exogenous photochemical crosslinking of tissular collagen, a process that leads to the decrease of venous compliance. As there are conflicting opinions on the role of compliance mismatch between arterial and venous conduits in a graft, this aspect was also considered in our review.

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Large animal model of vein grafts intimal hyperplasia: A systematic review

Cited by 6 publications

References 118 publications

External Support of Autologous Internal Jugular Vein Grafts with FRAME Mesh in a Porcine Carotid Artery Model

External Support of Autologous Internal Jugular Vein Grafts with FRAME Mesh in a Porcine Carotid Artery Model

Osteopontin Activation and Microcalcification in Venous Grafts Can Be Modulated by Dexamethasone

Therapeutic strategies based on non-ionizing radiation to prevent venous neointimal hyperplasia: the relevance for stenosed arteriovenous fistula, and the role of vascular compliance

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