Longitudinal Assessment of Hyperplasia Using Magnetic Resonance Imaging without Contrast in a Porcine Arteriovenous Graft Model

Terry, Christi M.; Kim, Seong Eun; Li, Li; Goodrich, K. Craig; Hadley, J. Rock; Blumenthal, Donald K.; Parker, Dennis L.; Cheung, Alfred K.

doi:10.1016/j.acra.2008.05.019

Cited by 16 publications

(19 citation statements)

References 32 publications

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“…Two radio-frequency receive-only phased-array coils were positioned over the AVF. MRI used a Siemens Trio 3T scanner and parameters described in Table 1 (Terry et al 2009). The total patient preparation and scan time was within one hour.…”

Section: Methodsmentioning

confidence: 99%

Serial analysis of lumen geometry and hemodynamics in human arteriovenous fistula for hemodialysis using magnetic resonance imaging and computational fluid dynamics

Terry

Nguyen

et al. 2013

Journal of Biomechanics

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The arteriovenous fistula (AVF) is the preferred form of vascular access for maintenance hemodialysis, but it often fails to mature to become clinically usable, likely due to aberrant hemodynamic forces. A robust pipeline for serial assessment of hemodynamic parameters and subsequent lumen cross-sectional area changes has been developed and applied to a data set from contrast-free MRI of a dialysis patient’s AVF collected over a period of months after AVF creation surgery. Black-blood MRI yielded images of AVF lumen geometry, while cine phase-contrast MRI provided volumetric flow rates at the in-flow and out-flow locations. Lumen geometry and flow rates were used as inputs for computational fluid dynamic (CFD) modeling to provide serial wall shear stress (WSS), WSS gradient, and oscillatory shear index profiles. The serial AVF lumen geometries were co-registered at 1-mm intervals using respective lumen centerlines, with the anastomosis as an anatomical landmark. Lumen enlargement was limited at the vein region near the anastomosis and a downstream vein valve, potentially attributed to a physical inhibition of wall expansion at those sites. This work is the first serial and detail study of lumen and hemodynamic changes in human AVF using MRI and CFD. This novel protocol will be used for a multicenter prospective study to identify critical hemodynamic factors that contribute to AVF maturation failure.

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Section: Methodsmentioning

confidence: 99%

Serial analysis of lumen geometry and hemodynamics in human arteriovenous fistula for hemodialysis using magnetic resonance imaging and computational fluid dynamics

Terry

Nguyen

et al. 2013

Journal of Biomechanics

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“…However, future work can use IVUS data for validation in patients who require a non-surgical graft intervention. High spatial resolution MR imaging of animal models [26] will allow serial imaging combined with histology data to further advance our understanding of graft disease.…”

Section: Discussionmentioning

confidence: 99%

Multi-contrast high spatial resolution black blood inner volume three-dimensional fast spin echo MR imaging in peripheral vein bypass grafts

Rybicki

Mitsouras

Owens

et al. 2010

Int J Cardiovasc Imaging

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The purpose of this study is to primarily evaluate the lumen area and secondarily evaluate wall area measurements of in vivo lower extremity peripheral vein bypass grafts patients using high spatial resolution, limited field of view, cardiac gated, black blood inner volume three-dimensional fast spin echo MRI. Fifteen LE-PVBG patients prospectively underwent ultrasound followed by T1-weighted and T2-weighted magnetic resonance (MR) imaging. Lumen and vessel wall areas were measured by direct planimetry. For graft lumen areas, T1- and T2-weighted measurements were compared with ultrasound. For vessel wall areas, differences between T1-and T2-weighted measurements were evaluated. There was no significant difference between ultrasound and MR lumen measurements, reflecting minimal MR blood suppression artifact. Graft wall area measured from T1-weighted images was significantly larger than that measured from T2-weighted images (P < 0.001). The mean of the ratio of T1-versus T2-weighted vessel wall areas was 1.59 (95% CI: 1.48–1.69). The larger wall area measured on T1-weighted images was due to a significantly larger outer vessel wall boundary. Very high spatial resolution LE-PVBG vessel wall MR imaging can be performed in vivo, enabling accurate measurements of lumen and vessel wall areas and discerning differences in those measures between different tissue contrast weightings. Vessel wall area differences suggest that LE-PVBG vessel wall tissues produce distinct signal characteristics under T1 and T2 MR contrast weightings.

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“…The protocol used in this study was approved by the Institutional Animal Care and Use Committee of the University of Utah (IACUC Permit Number 11-08008). Female Yorkshire cross domestic swine (~30 kg) (Sigma Livestock, Salt Lake City, UT) were sedated with intramuscular injection of a Telezol® cocktail (ketamine 3–5 mg/kg (Hospira Inc.), tiletamine/zolazepam 3–5 mg/kg (Fort Dodge Animal Health), xylaxine 6–10 mg/kg (Lloyd Laboratories, Shenandoah, IA)) and then anesthesia was maintained with isofluorane gas (1–3%) inhalation as previously described by us [15, 35, 36]. All surgeries were performed under sterile conditions.…”

Section: Methodsmentioning

confidence: 99%

“…The minced fat was placed perivascular to the vein and the wound was sutured closed and the animals were allowed to recover. For efficacy studies, a porcine model of arteriovenous graft that has been described in detail previously [14, 15, 35, 36] was used. In sedated animals, under sterile conditions, a spiral-reinforced expanded synthetic polytetrafluoroethylene (PTFE) graft (7-cm length, 6-mm internal diameter) was placed between the common carotid artery and the ipsilateral external jugular vein such that blood flow from the carotid was partially shunted into the vein via the interposing graft.…”

Section: Methodsmentioning

confidence: 99%

“…Post-operative analgesia was provided to all animals by intramuscular injection of buprenorphine hydrochloride (0.01 mg/kg; Reckitt Benckiser Healthcare Ltd., Hull, England) and application of a fentanyl patch (50 mg) (Watson Laboratories, Inc. Corona, CA). The control and treated pigs with graft were maintained for four weeks whereupon they were imaged by MRI to obtain a measure of the open lumen area at the anastomosis of graft and vein as previously described[36]. …”

Section: Methodsmentioning

confidence: 99%

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Autologous fat transplants to deliver glitazone and adiponectin for vasculoprotection

Sanders

Zhuplatov

et al. 2017

Journal of Controlled Release

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The insulin sensitizing glitazone drugs, rosiglitazone (ROS) and pioglitazone (PGZ) both have anti-proliferative and anti-inflammatory effects and induce adipose tissue (fat) to produce the vaso-protective protein adiponectin. Stenosis due to intimal hyperplasia development often occurs after placement of arteriovenous synthetic grafts used for hemodialysis. This work was performed to characterize the in vitro and in vivo effects of ROS or PGZ incorporation in fat and to determine if fat/PGZ depots could decrease vascular hyperplasia development in a porcine model of hemodialysis arteriovenous graft stenosis. Powdered ROS or PGZ (6–6000 μM) was mixed with fat explants and cultured. Drug release from fat was quantified by HPLC/MS/MS, and adiponectin and monocyte chemotactic protein-1 (MCP-1) levels in culture media were measured by ELISA. The effect of conditioned media from the culture of fat with ROS or PGZ on i) platelet-derived growth factor-BB (PDGG-BB)-stimulated proliferation of human venous smooth muscle cells (SMC) was measured by a DNA-binding assay, and ii) lipopolysaccharide (LPS)-induced human monocyte release of tumor necrosis factor-alpha (TNFα) was assessed by ELISA. In a porcine model, pharmacokinetics of PGZ from fat depots transplanted perivascular to jugular vein were assessed by HPLC/MS/MS, and retention of the fat depot was monitored by MRI. A porcine model of synthetic graft placed between carotid artery and ipsilateral jugular vein was used to assess effects of PGZ/fat depots on vascular hyperplasia development. Both ROS and PGZ significantly induced the release of adiponectin and inhibited release of MCP-1 from the fat. TNF production from monocytes stimulated with LPS was inhibited 50–70% in the presence of media conditioned by fat alone or fat and either drug. The proliferation of SMC was inhibited in the presence of media conditioned by fat/ROS cultures. Fat explants placed perivascular to the external jugular vein were retained, as confirmed by MRI at one week after placement. PGZ was detected in the fat depot, in the external jugular vein wall and in adjacent tissue at clinically relevant levels, whereas levels in plasma were below detection. External jugular vein exposed to fat incorporated with PGZ had increased adiponectin expression compared to vein exposed to fat alone. However, the development of hyperplasia within the arteriovenous synthetic grafts was unchanged by treatment with fat/PGZ depots compared to no treatment.

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Longitudinal Assessment of Hyperplasia Using Magnetic Resonance Imaging without Contrast in a Porcine Arteriovenous Graft Model

Cited by 16 publications

References 32 publications

Serial analysis of lumen geometry and hemodynamics in human arteriovenous fistula for hemodialysis using magnetic resonance imaging and computational fluid dynamics

Serial analysis of lumen geometry and hemodynamics in human arteriovenous fistula for hemodialysis using magnetic resonance imaging and computational fluid dynamics

Multi-contrast high spatial resolution black blood inner volume three-dimensional fast spin echo MR imaging in peripheral vein bypass grafts

Autologous fat transplants to deliver glitazone and adiponectin for vasculoprotection

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