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Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model.

Publication ,  Journal Article
Seipelt, RG; Backer, CL; Mavroudis, C; Stellmach, V; Seipelt, IM; Cornwell, M; Hernandez, J; Crawford, SE
Published in: Circulation
September 9, 2003

BACKGROUND: Recurrent stenosis after extended end-to-end anastomosis for aortic coarctation is the primary indication for further interventions in children. Tension because of the extended resection and local arterial wall hypoxia are possible pathogenetic mechanisms. We hypothesized that (1) tension interferes with healing and (2) that vascular endothelial growth factor (VEGF), a hypoxia sensitive angiogenic inducer, may enhance healing of the vascular anastomosis. METHODS AND RESULTS: In a model of coarctation repair, rabbits underwent thoracic aortic end-to-end anastomosis after transection (no-tension; n=15), resection of an aortic ring (tension; n=14) or resection and topical VEGF treatment (0.75 microg VEGF165; tension+VEGF; n=14). Gross and histologic characteristics of the aortic wall were assessed at 1 week, 1 and 2 months. In the tension only group at 1 month, the severity of vascular remodeling was increased with fibrosis and calcification compared with controls. At 2 months, this group also revealed more luminal stenosis (29% versus 19%; P<0.001). Exogenous VEGF resulted in significantly less fibrosis, calcification and chondroid metaplasia at 1 month (P<0.05) and luminal area was only reduced 3% at 2 months (P<0.001 versus tension group). CONCLUSIONS: In a rabbit model of coarctation repair, the addition of tension on the vascular anastomosis resulted in poor healing and luminal stenosis. Topical VEGF maintained luminal integrity by decreasing fibrosis and calcification. These findings suggest that topical VEGF may be a promising new strategy to enhance healing and improve the outcome of vascular anastomoses for coarctation of the aorta.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

September 9, 2003

Volume

108 Suppl 1

Start / End Page

II150 / II154

Location

United States

Related Subject Headings

  • Wound Healing
  • Vascular Endothelial Growth Factors
  • Vascular Endothelial Growth Factor A
  • Rabbits
  • Male
  • Lymphokines
  • Intercellular Signaling Peptides and Proteins
  • Endothelial Growth Factors
  • Constriction, Pathologic
  • Combined Modality Therapy
 

Citation

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Seipelt, R. G., Backer, C. L., Mavroudis, C., Stellmach, V., Seipelt, I. M., Cornwell, M., … Crawford, S. E. (2003). Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model. Circulation, 108 Suppl 1, II150–II154. https://doi.org/10.1161/01.cir.0000087388.15066.1f
Seipelt, Ralf G., Carl L. Backer, Constantine Mavroudis, Veronica Stellmach, Ingrid M. Seipelt, Mona Cornwell, Jose Hernandez, and Susan E. Crawford. “Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model.Circulation 108 Suppl 1 (September 9, 2003): II150–54. https://doi.org/10.1161/01.cir.0000087388.15066.1f.
Seipelt RG, Backer CL, Mavroudis C, Stellmach V, Seipelt IM, Cornwell M, et al. Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model. Circulation. 2003 Sep 9;108 Suppl 1:II150–4.
Seipelt, Ralf G., et al. “Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model.Circulation, vol. 108 Suppl 1, Sept. 2003, pp. II150–54. Pubmed, doi:10.1161/01.cir.0000087388.15066.1f.
Seipelt RG, Backer CL, Mavroudis C, Stellmach V, Seipelt IM, Cornwell M, Hernandez J, Crawford SE. Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model. Circulation. 2003 Sep 9;108 Suppl 1:II150–II154.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

September 9, 2003

Volume

108 Suppl 1

Start / End Page

II150 / II154

Location

United States

Related Subject Headings

  • Wound Healing
  • Vascular Endothelial Growth Factors
  • Vascular Endothelial Growth Factor A
  • Rabbits
  • Male
  • Lymphokines
  • Intercellular Signaling Peptides and Proteins
  • Endothelial Growth Factors
  • Constriction, Pathologic
  • Combined Modality Therapy