The Role of External Banding Valvuloplasty with the Venocuff in the Treatment of Primary Deep Venous Insufficiency

Guarnera, Giorgio; Furgiuele, Sergio; Camilli, S

doi:10.1177/026835559400900404

Cited by 5 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…53 This method can be accomplished using a commercially available kit (Venocuff II, Imthage, Australia) and it has been shown to work fairly well in specific clinical cases. 8,54 Therefore, VEHTC can be designed to serve as both a stent and an actively contracting pump. Self-adjustable pump:Venous EHT cuffswill be intrinsically myogenic, that is, upon more stretch, its contraction will be stronger according to the Frank-Starling mechanism.…”

Section: Number Of Vehtcsmentioning

confidence: 99%

Thinking Outside the Heart

Sarvazyan

2014

J Cardiovasc Pharmacol Ther

View full text Add to dashboard Cite

This article considers the use of autologous stem cell-derived cardiomyocytes as a novel means to aid venous return. The approach consists of creating external cuffs of engineered heart tissue around vein segments with incompetent or poorly competent valves. The engineered heart tissue cuff prevents distention of the impaired vein segments and aids unidirectional flow by its rhythmic contractions. There appear to be no fundamental limitations to this approach as feasibility of all of the individual components has already been shown. Here, we underline the clinical need for novel ways to treat chronic deep venous insufficiency, review previous research that enabled this approach, consider potential designs of engineered heart tissue cuffs, and outline its advantages and future challenges.

show abstract

Section: Number Of Vehtcsmentioning

confidence: 99%

Thinking Outside the Heart

Sarvazyan

2014

J Cardiovasc Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Primary venous insufficiency occurs when there is weakness of the vein wall or of the venous valve leaflets. 1–6 External banding valvuloplasty (EBV) of the vein can be used in cases of primary vein incompetence to restore valve function. EBV of the great saphenous vein (GSV) in patients with varicose veins showed satisfactory results.…”

Section: Introductionmentioning

confidence: 99%

A NiTi alloy-based cuff for external banding valvuloplasty: a six-week follow-up study in pigs

et al. 2011

View full text Add to dashboard Cite

show abstract

“…This in turn may reduce ion diffusion from this material [40] as compared to conventional metals. Although nickel is an essential trace element within the body [8,10,13], the primary concern regarding nitinol relates to the high nickel content of the material and the possibility of hypersensitivity [17,19], and toxic [11,30] or carcinogenic [16,26] effects from increased nickel release into the body [13,33,40]. The chemical surface structure, the surface consistency, surface energy and corrosion resistance are therefore very important parameters defining implant biocompatibility [2].…”

Section: Introductionmentioning

confidence: 99%

In vitro evaluation of a nitinol based vein cuff for external valvuloplasty

Hiebl

Jung

Schossig

et al. 2010

Clinical Hemorheology and Microcirculation

View full text Add to dashboard Cite

This study shows first in vitro tests of a nitinol based vein cuff developed for external valvuloplasty. In contrary to currently existing vein cuffs the tested model enables minimal invasive implantation and also maintains its round pre-shaped profile at body temperature (37 • C). The examination of the cuff surface structure by scanning electron microscopy, profilometry and X-ray photoelectron spectroscopy after sterilization with ethylene oxide and before cyto-compatibility testing revealed a nearly smooth surface (mean square roughness Rq 66 ± 33 nm) which was primarily composed of nickel, oxygen, titanium, carbon and silicon where nickel was the least fraction (Ni: 0.7%, Ti: 1.7%, Si: 15.8%, O: 29.5%, C: 52.3%) of the surface elements. Si and C are supposed to be contaminations caused by a final cuff polishing with silicon carbide at the end of the manufacturing process. To evaluate cyto-compatibility initial cell adherence and cell activity were assessed. The results showed good initial cell adherence of L929 fibroblast-like cells on the cuff surface already after 24 h. The results also revealed no inhibitory effects on the activity of these cells (MTS test) later on. The test setup developed to analyse functionality in a dynamic mode was shown to be suited at blood pressures up to 300 mmHg. The cuff successfully limited dilation of varicose veins (Vena saphena magna) at physiological blood pressures (<120 mmHg) and also in cases of hypertonia (300 mmHg) to the diameter determined by the cuff (4.0 mm) over the complete testing period. This indicates that the clasp based cuff closure mechanism is suited to close the cuff under variable physiological and pathological blood pressure conditions. The cuff structure only allowed minimal adaptation on the inhomogenously dilating vein profile in the both peripheral cuff modules. Both peripheral modules followed the vessel dilation in correlation to the applied pressure. At pressures within the physiological range (≤120 mmHg) the variation of the lateral arch module diameter was only marginal, whereas at 300 mmHg pressure the peripheral modules followed vein dilation up to a diameter of 5.0 to 5.5 mm. The cuff also maintained the pre-shaped round profile in the central and peripheral modules during the pressure increase and the consecutive cuff expansion. The study showed that the first nitinol based vein cuff for external valvuloplasty was processed well enough by electropolishing and sterilization to allow culturing of L929 fibroblast-like cells on the cuff surface as a test of general biocompatibility. The cuff also proved to limit dilation of varicose veins at physiological and pathological blood pressures in vitro. Further tests with primary cells from the venous wall will follow to test the specific biocompatibility before tests in vivo can be envisaged.

show abstract

The Role of External Banding Valvuloplasty with the Venocuff in the Treatment of Primary Deep Venous Insufficiency

Cited by 5 publications

References 3 publications

Thinking Outside the Heart

Thinking Outside the Heart

A NiTi alloy-based cuff for external banding valvuloplasty: a six-week follow-up study in pigs

In vitro evaluation of a nitinol based vein cuff for external valvuloplasty

Contact Info

Product

Resources

About