Patches of different types for carotid patch angioplasty

Orrapin, Saritphat; Benyakorn, Thoetphum; Howard, Dominic P J; Siribumrungwong, Boonying

doi:10.1002/14651858.cd000071.pub4

Cited by 8 publications

(9 citation statements)

References 49 publications

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“…Vascular patches are commonly applied in tissue repair and reconstruction in congenital cardiac surgery, including pulmonary arterioplasty, right ventricular outflow tract patching, valve leaflet augmentation, veins as well as unroofed coronary sinus repair ( Gao et al, 2019 ; Lu et al, 2020 ). Vascular patches are also used for defect correction in endarterectomy surgery to restore carotid artery patency ( Orrapin et al, 2021 ). The vascular patch provides mechanical support and is perfect for tissue regeneration.…”

Section: Discussionmentioning

confidence: 99%

Mitomycin-Treated Endothelial and Smooth Muscle Cells Suitable for Safe Tissue Engineering Approaches

Захарова

Saaya

Shevchenko

et al. 2022

Front. Bioeng. Biotechnol.

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In our previous study, we showed that discarded cardiac tissue from the right atrial appendage and right ventricular myocardium is an available source of functional endothelial and smooth muscle cells for regenerative medicine and tissue engineering. In the study, we aimed to find out what benefits are given by vascular cells from cardiac explants used for seeding on vascular patches engrafted to repair vascular defects in vivo. Additionally, to make the application of these cells safer in regenerative medicine we tested an in vitro approach that arrested mitotic division to avoid the potential tumorigenic effect of dividing cells. A tissue-engineered construction in the form of a patch based on a polycaprolactone-gelatin scaffold and seeded with endothelial and smooth muscle cells was implanted into the abdominal aorta of immunodeficient SCID mice. Aortic patency was assessed using ultrasound, MRI, immunohistochemical and histological staining. Endothelial and smooth muscle cells were treated with mitomycin C at a therapeutic concentration of 10 μg/ml for 2 h with subsequent analysis of cell proliferation and function. The absence of the tumorigenic effect of mitomycin C-treated cells, as well as their angiogenic potential, was examined by injecting them into immunodeficient mice. Cell-containing patches engrafted in the abdominal aorta of immunodeficient mice form the vessel wall loaded with the appropriate cells and extracellular matrix, and do not interfere with normal patency. Endothelial and smooth muscle cells treated with mitomycin C show no tumorigenic effect in the SCID immunodeficient mouse model. During in vitro experiments, we have shown that treatment with mitomycin C does not lead to a decrease in cell viability. Despite the absence of proliferation, mitomycin C-treated vascular cells retain specific cell markers, produce specific extracellular matrix, and demonstrate the ability to stimulate angiogenesis in vivo. We pioneered an approach to arresting cell division with mitomycin C in endothelial and smooth muscle cells from cardiac explant, which prevents the risk of malignancy from dividing cells in vascular surgery. We believe that this approach to the fabrication of tissue-engineered constructs based on mitotically inactivated cells from waste postoperative material may be valuable to bring closer the development of safe cell products for regenerative medicine.

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Section: Discussionmentioning

confidence: 99%

Mitomycin-Treated Endothelial and Smooth Muscle Cells Suitable for Safe Tissue Engineering Approaches

Захарова

Saaya

Shevchenko

et al. 2022

Front. Bioeng. Biotechnol.

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“…probabilidades de inestabilidad hemodinámica y 1.8 veces las probabilidades de permanecer en el hospital durante > 1 día 11,12 . La incidencia de EVC en pacientes en los que se usó anestesia local fue del 3.2%, en comparación con el 3.5% en el grupo de anestesia general.…”

Section: Abstract: Carotid Endarterectomy Atherosclerosis Cerebral Vascular Event Surgical Reinterventionunclassified

“…Con el uso de parche de vena o parche de politetrafluoroetileno (PTFE) para el cierre de ECA se ha observado que disminuye el riesgo de trombosis carotídea perioperatoria, EVC y reestenosis tardía del sitio de la endarterectomía 11 . Se ha reportado mayor incidencia de la dilatación aneurismática con el uso del parche de vena vs. el grupo de PTFE 12 .…”

Section: Abstract: Carotid Endarterectomy Atherosclerosis Cerebral Vascular Event Surgical Reinterventionunclassified

Complicaciones posquirúrgicas en pacientes sometidos a endarterectomía carotídea. Estudio transversal

Benítez-Rodríguez¹,

Calderón-Llamas²,

Nuño‐Escobar³

et al. 2021

RMA

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La estenosis carotídea por ateroesclerosis es causante del 15-30% de enfermedad vascular cerebral (EVC) de origen isquémico y en 2020 representó la séptima causa de muerte en México. La endarterectomía carotídea (ECA) es el tratamiento de elección para prevenir un EVC en pacientes con estenosis carotídea sintomática. Las complicaciones asociadas al tratamiento son infarto agudo al miocardio, hemorragia/hematomas, daño a nervios periféricos, EVC y muerte en el posquirúrgico inmediato. Objetivo: Determinar la prevalencia de las complicaciones posquirúrgicas en pacientes sometidos a endarterectomía por estenosis carotídea. Material y métodos: Estudio transversal analítico. Se analizaron pacientes como grupo 1 (con complicaciones, n = 6), grupo 2 (sin complicaciones, n = 16). Se utilizó estadística descriptiva, comparativa e inferencial, se determinó un valor de p < 0.05 como estadísticamente significativo. Se empleó el programa estadístico IBM SPSS V.28. Resultados: Se evaluaron 22 pacientes sometidos a ECA. La prevalencia de complicaciones fue del 27%. La complicación más frecuente fue reintervención, en el 22.7% (n = 5), seguida de EVC 13.6% (n = 3), hematoma/hemorragia 9% (n = 2) y secuela neurológica periférica 4.5% (n = 1). Conclusiones: La necesidad de reintervención quirúrgica por hemorragia secundaria a la intervención y el EVC fueron las complicaciones mas frecuentemente encontradas (intervalo de confianza del 95%: 0.59-0.99 [p < 0.001] vs. 0.8-0.45 [p = 0.023]). Estos hallazgos serán útiles para posibles manejos perioperatorios en pacientes con estenosis carotídea.

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“…One of them, there is no consensus on the best patch material to use in such patients. Dacron, polytetrafluoroethylene, great saphenous vein, and bovine pericardium are the commonly used patch materials, and there are many studies in the literature about these patches (4). The use of autologous pericardium as an alternative carotid patch in concomitant carotid endarterectomy (CEA) and CABG surgery in four cases has been described previously (5).…”

Section: Introductionmentioning

confidence: 99%

Eş zamanlı karotis endarterektomi ve koroner arter baypas greftleme operasyonu yapılan hastalarda otolog perikard alternatif bir karotis yama materyali olabilir.

et al. 2022

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Backround: Dacron, polytetrafluoroethylene, great saphenous vein, and bovine pericardium are the commonly used as patch materials. However, there is no study about autologous pericardial as a patch material in carotid endarterectomy surgery. We aimed to assess the results of the use of autologous pericardial patch in patients undergoing concomitant carotid endarterectomy and coronary artery by-pass graft surgery. Materials and Methods:: The study involved 30 patients who underwent concomitant carotid endarterectomy with patch angioplasty and coronary artery bypass grafting surgery from January 2016 to February 2020. Patchplasty is performed with autologous pericardium for 13 patients and dacron patch for 17 patients during carotid endarterectomy. Results: No statistical difference was found between the groups in terms of reoperation, arterial occlusion, restenosis, operation time, and neurological events. In the postoperative follow-up, it was determined that the amount of drainage from the area on which the carotid surgery was applied was less in the those in whom autologous pericardium was used compared to those in whom Dacron patch was used. (p=0.001) Conclusion: We concluded that the use of autologous pericardium as a carotid artery patch is a safe, feasible, and effective method in patients undergoing combined carotid artery and coronary bypass surgery.

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Patches of different types for carotid patch angioplasty

Cited by 8 publications

References 49 publications

Mitomycin-Treated Endothelial and Smooth Muscle Cells Suitable for Safe Tissue Engineering Approaches

Mitomycin-Treated Endothelial and Smooth Muscle Cells Suitable for Safe Tissue Engineering Approaches

Complicaciones posquirúrgicas en pacientes sometidos a endarterectomía carotídea. Estudio transversal

Eş zamanlı karotis endarterektomi ve koroner arter baypas greftleme operasyonu yapılan hastalarda otolog perikard alternatif bir karotis yama materyali olabilir.

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