Can endothelial seeding enhance patency and inhibit neointimal hyperplasia? Experimental studies and clinical trial of endothelial seeded venous prostheses

Z. G. Wang, H. Zhang, Lee Li-Qun Pu, W. Du, G. D. Li, J. D. Wu, D. J. Wang, R. Y. Sha

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background. Venous prostheses have poor long-term patency; to improve this situation, experimental studies have been carried out. Methods. Methods of endothelial cell harvesting, prosthetic seeding and implantation mainly in the inferior vena cava were studied in 127 dogs. Evaluations were conducted by angiography, gross appearance, light, scanning and transmission electron microscopic observations, histo-fluorescent staining, as well as radioimmunoassay. Results. It was found that at five to ten days following implantation, the prosthetic endothelialisation could be reliably achieved in the seeded group and a 100% patency of the seeded inferior vena caval prostheses was attained at 100 days. The thickness of the neointima in the seeded group at 10 and 100 days was 299 λm and 302 λm, respectively. The metabolite of PGI2 from extrinsic arachidonic acid, 6-keto PGF1a, produced by cells from seeded graft was significantly higher than that from spontaneously formed cells and the reverse found with thromboxane B2. A temporary (one week) distal (femoral) arteriovenous fistula enhanced graft patency. These results indicated that the early endothelialisation of grafts by seeding enhanced the patency and inhibited intimal hyperplasia of venous prostheses. The clinical outcome was impressively improved from our previous experience with ten of eleven venous grafts patent over a follow-up period of six to nine years. These might result from the realization of early endothelialisation and its cells derived from seeding being able to produce significantly more PGI2 and less thromboxane B2. Conclusions. The endothelial cell seeding technique may bring us much closer to an ideal venous prosthesis.

Original languageEnglish (US)
Pages (from-to)259-269
Number of pages11
JournalInternational Angiology
Volume19
Issue number3
StatePublished - 2000
Externally publishedYes

Fingerprint

Prostheses and Implants
Hyperplasia
Clinical Trials
Transplants
Thromboxane B2
Epoprostenol
Endothelial Cells
Tunica Intima
Neointima
Venae Cavae
Arteriovenous Fistula
Inferior Vena Cava
Thigh
Arachidonic Acid
Radioimmunoassay
Angiography
Dogs
Electrons
Staining and Labeling
Light

Keywords

  • Blood vessel prosthesis
  • Budd-Chiari syndrome
  • Cells, cultured
  • Endothelium vascular
  • Hepatic vein thrombosis
  • Veins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Can endothelial seeding enhance patency and inhibit neointimal hyperplasia? Experimental studies and clinical trial of endothelial seeded venous prostheses. / Wang, Z. G.; Zhang, H.; Pu, Lee Li-Qun; Du, W.; Li, G. D.; Wu, J. D.; Wang, D. J.; Sha, R. Y.

In: International Angiology, Vol. 19, No. 3, 2000, p. 259-269.

Research output: Contribution to journalArticle

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AU - Li, G. D.

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N2 - Background. Venous prostheses have poor long-term patency; to improve this situation, experimental studies have been carried out. Methods. Methods of endothelial cell harvesting, prosthetic seeding and implantation mainly in the inferior vena cava were studied in 127 dogs. Evaluations were conducted by angiography, gross appearance, light, scanning and transmission electron microscopic observations, histo-fluorescent staining, as well as radioimmunoassay. Results. It was found that at five to ten days following implantation, the prosthetic endothelialisation could be reliably achieved in the seeded group and a 100% patency of the seeded inferior vena caval prostheses was attained at 100 days. The thickness of the neointima in the seeded group at 10 and 100 days was 299 λm and 302 λm, respectively. The metabolite of PGI2 from extrinsic arachidonic acid, 6-keto PGF1a, produced by cells from seeded graft was significantly higher than that from spontaneously formed cells and the reverse found with thromboxane B2. A temporary (one week) distal (femoral) arteriovenous fistula enhanced graft patency. These results indicated that the early endothelialisation of grafts by seeding enhanced the patency and inhibited intimal hyperplasia of venous prostheses. The clinical outcome was impressively improved from our previous experience with ten of eleven venous grafts patent over a follow-up period of six to nine years. These might result from the realization of early endothelialisation and its cells derived from seeding being able to produce significantly more PGI2 and less thromboxane B2. Conclusions. The endothelial cell seeding technique may bring us much closer to an ideal venous prosthesis.

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