Use of arterial patch to improve re-endothelialization in a sheep model of open carotid endarterectomy. An incentive to use internal thoracic artery as an on-lay patch following coronary endarterecomy?

Bezon, Eric; Khalifa, Ahmed Aziz; Gal, Grégoire Le; Choplain, J.-N.; Mansourati, Jacques; Barra, J. A.

doi:10.1510/icvts.2008.198317

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…[26][27][28] Thrombosis and neointimal hyperplasia could be reduced by rapid endothelialization of the artificial blood vessels. 29 In the 8th week after patch angioplasties, the inner surface of the PCU patch was almost completely endothelialized. 16 In our study, the lumen surfaces of the artificial blood vessels were covered by endothelia in various degrees, and the average endothelialization rate was 69.44% (Figure 7).…”

Section: Discussionmentioning

confidence: 97%

The novel hybrid polycarbonate polyurethane / polyester three-layered large-diameter artificial blood vessel

Tian

Qin

et al. 2021

J Biomater Appl

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Background The most common materials of artificial blood vessels are polyethylene terephthalate and polytetrafluoroethylene. But polycarbonate polyurethane (PCU) is an ideal material for vascular prostheses because of their excellent characteristics. As far as we know, our artificial blood vessel is the first type of hybrid PCU/polyester three-layered large-diameter artificial blood vessel in the world. Objective The purpose of this preclinical animal experiment is to evaluate the hemocompatibility, histocompatibility, effectiveness, and safety of the three-layered large-diameter artificial blood vessel in sheep. Methods The artificial blood vessels took place of the initial segments of the sheep’s thoracic aorta by end-to-end anastomosis. Results All of the 14 sheep are male, their average body weight (BW) was 30.57 ± 3.95 kg. All 14 artificial blood vessels successfully replaced the thoracic aortas. 5 sheep did not survive to the end of the experiment, while the remaining 9 sheep did. After the surgery, the blood biochemical and blood routine indicators fluctuate slightly within the normal range. The angiography showed that the implanted artificial blood vessels were unobstructed without obvious stenosis or expansion. 24 weeks after surgery, the lumen surfaces of the artificial blood vessels were covered by endothelia in different degrees, and the average endothelialization rate was 69.44% (range: 20% to 100%). Conclusions This artificial blood vessel is the first to use PCU in large-diameter artificial vascular grafts. It has excellent blood compatibility, wonderful biocompatibility, high endothelialization rate, and 100% patency.

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Section: Discussionmentioning

confidence: 97%

The novel hybrid polycarbonate polyurethane / polyester three-layered large-diameter artificial blood vessel

Tian

Qin

et al. 2021

J Biomater Appl

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“…[29][30][31] Rapid endothelialization of the graft decreases thrombotic complications and neointimal hyperplasia. 32 Therefore, we decided to assess endothelialization at an early time point: after two weeks, a large number of CD31þ endothelial cells were present at the luminal side of all three patch materials without an obvious difference between the three materials. After two months, we noticed a nearly complete endothelialization of all patch materials without differences between the groups.…”

Section: Discussionmentioning

confidence: 99%

In vivo endothelialization and neointimal hyperplasia assessment after angioplasty of sheep carotid artery with a novel polycarbonate polyurethane patch

et al. 2019

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The aim of this study was to compare two variants of a novel polycarbonate polyurethane prosthesis with polyethylene terephthalate (Dacron) prosthesis in an established sheep model of carotid patch angioplasty. Two variants of the polycarbonate polyurethane prosthesis were used: (1) Polycarbonate polyurethane equal (PCU-e) prosthesis consisted of a multilayered porous structure with equal internal and external layers; (2) Polycarbonate polyurethane with more porous inner layers (PCU-mp) prosthesis had more porous inner layers than external layers. Carotid patch angioplasty was performed in 12 sheep: in six sheep, the PCU-e variant and in the other six sheep, the PCU-mp variant was implanted. Dacron patches were implanted in the contralateral carotid artery of all sheep as a control. Half of the animals with each polycarbonate polyurethane variant were euthanized after two weeks and the other half after eight weeks. Cellular infiltration, endothelialization, and neointimal hyperplasia were examined. All grafts were patent, and no thrombus was seen in any of the harvested arteries. The pores of all the three patch materials allowed infiltration of inflammatory cells, capillaries, and connective tissue. After eight weeks, a nearly complete endothelialization was visible in all patch groups without an obvious difference between the three patch materials. The neointima was thinner in the PCU patches (PCU-e: 56 ± 13 µm, PCU-mp: 119 ± 60 µm) when compared to Dacron patches (156 ± 64 µm) after two weeks. After 8 weeks, a further neointimal growth was detectable, without any significant difference of neointimal thickness between the three patch materials (Dacron: 274 ± 82 µm, PCU-e: 324 ± 98 µm, PCU-mp: 235 ± 59 µm). With the novel polycarbonate polyurethane patch materials, we achieved promising functional and morphological results with 100% patency and nearly complete endothelialization. Our findings showed at least a non-inferiority of the novel polycarbonate polyurethane patch material compared to Dacron. There were no significant differences detected between the two polycarbonate polyurethane patch variants.

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“…Marked increases in mechanical stretch on coarse vascular lumens resulting from exposure to the arterial circulation has been demonstrated to induce apoptosis of ECs in a sheep model of open carotid endarterectomy (5). This mechanical stretch-induced vascular injury may contribute to the subsequent excessive inflammatory response and rapid EC apoptosis, which can ultimately result in stenosis and thrombosis (6).…”

Section: Discussionmentioning

confidence: 99%

“…We placed Bulldog hemostatic clamps on the abdominal aorta to stop blood flow temporarily. The model of abdominal aortic endarterectomy was performed by denudation in the control and study groups as previously described (5,6). To confirm the establishment of the model of electrocautery, the blocked abdominal aorta was partially incised and electrocautery via an electrocoagulation electrotome was performed through the entire lumen with the following parameters: 1W+1S, 1W+2S, 2W+1S and 2W+2S (Fig.…”

Section: Methodsmentioning

confidence: 99%

Intravascular application of electrocautery in a rabbit model of abdominal aortic endarterectomy

Wang

et al. 2017

Experimental and Therapeutic Medicine

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Effective therapies for preventing perioperative complications such as thrombosis and inflammation after coronary endarterectomy (CE) are lacking. Electrocoagulation electrotomes have been routinely used in surgery for their cutting, clotting, and hemostatic properties. As strong flattening tools, their electrocautery function may prevent mechanical intimal-adventitial injury to arterial circulation and attenuate stenosis. The present study investigated the effects of intravascular application of electrocautery on ameliorating inflammation and thrombosis in a rabbit model of abdominal aortic endarterectomy. New Zealand rabbits were randomly divided into the sham, control (endarterectomy), and study (endarterectomy + electrocautery) groups with 10 in each group. Abdominal aortas were partially blocked and intima was removed. Electrocautery was performed with an electrocoagulation electrotome through the entire blocked vessel lumen. Vascular ultrasound parameters, molecular biological and histological characteristics of the abdominal aorta including vascular diameter, blood flow velocity, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels, and apoptosis rate of vascular endothelial cells (ECs) were evaluated postoperatively by vascular Doppler ultrasound, ELISA, real-time RT-PCR, flow cytometry, and immunofluorescence at various time points. Compared with the endarterectomy + electrocautery group, the isolated endarterectomy group had significantly increased levels and gene expression of TNF-α and IL-6 (P<0.05), and rates of apoptosis of vascular ECs (P<0.05), with gradual vascular stenosis and decreased blood flow velocity. In conclusion, intravascular application of electrocautery has favorable short-term effects on the abdominal aorta and can reduce inflammation in a rabbit model of abdominal aorta endarterectomy. Long-term anti-inflammatory and anti-thrombotic effects on arterial remodeling and the clinical value of electrocautery in CE remain to be determined.

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Use of arterial patch to improve re-endothelialization in a sheep model of open carotid endarterectomy. An incentive to use internal thoracic artery as an on-lay patch following coronary endarterecomy?

Cited by 8 publications

References 14 publications

The novel hybrid polycarbonate polyurethane / polyester three-layered large-diameter artificial blood vessel

The novel hybrid polycarbonate polyurethane / polyester three-layered large-diameter artificial blood vessel

In vivo endothelialization and neointimal hyperplasia assessment after angioplasty of sheep carotid artery with a novel polycarbonate polyurethane patch

Intravascular application of electrocautery in a rabbit model of abdominal aortic endarterectomy

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