A novel biodegradable external mesh stent improved long-term patency of vein grafts by inhibiting intimal–medial hyperplasia in an experimental canine model

Atsuhiko Sato, Shunsuke Kawamoto, Mika Watanabe, Yusuke Suzuki, Goro Takahashi, Naoki Masaki, Kiichiro Kumagai, Yoshifumi Saijo, Koichi Tabayashi, Yoshikatsu Saiki

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: Increased hemodynamic stress on vein grafts used in the arterial system is associated with vein graft disease. We determined whether a novel biodegradable external mesh stent could inhibit medial–intimal hyperplasia by suppressing hemodynamic stress on vein grafts and improve long-term patency. Methods: Twenty-four beagles underwent bilateral femoral interposition grafting using reversed femoral veins. Vein grafts were externally supported by a novel poly l-lactide-ε-caprolactone copolymer (P(LA/CL)) biodegradable mesh stent or a nonabsorbable mesh stent. Vein grafts with no reinforcement were used as controls. The grafts were harvested 6 and 12 months after implantation for morphometric and immunohistochemical assessment. Results: The endoluminal circumferential vein graft length was smaller in the P(LA/CL) and nonabsorbable groups (17.2 ± 2.9 and 19.0 ± 0.3 mm, respectively), than that in the control group (25.0 ± 2.6 mm, P < 0.01) at 12 months. The mean intimal–medial thickness was thinner in P(LA/CL) and nonabsorbable stent groups (0.18 ± 0.05 and 0.16 ± 0.05 mm, respectively), than that in the control group (0.30 ± 0.08 mm, P < 0.01). Differences in the intimal–medial thickness among the groups were associated with the magnitude of cellular proliferating activity. The graft patency ratio (100 %) was higher in the P(LA/CL) group than that in the nonabsorbable and control groups (72.2 and 63.6 %, respectively, P < 0.05). Conclusions: The biodegradable P(LA/CL) external mesh stent improved vein graft patency for 12 months and prevented vein graft dilatation and intimal hyperplasia associated with suppressed neointimal layer cellular proliferating activity.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalGeneral thoracic and cardiovascular surgery
Volume64
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

Keywords

  • Biodegradable stent
  • External support
  • Intimal hyperplasia
  • Vein graft

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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