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An early study on the mechanisms that allow tissue-engineered vascular grafts to resist intimal hyperplasia.

Publication ,  Journal Article
Prichard, HL; Manson, RJ; DiBernardo, L; Niklason, LE; Lawson, JH; Dahl, SLM
Published in: J Cardiovasc Transl Res
October 2011

Intimal hyperplasia is one of the prominent failure mechanisms for arteriovenous fistulas and arteriovenous access grafts. Human tissue-engineered vascular grafts (TEVGs) were implanted as arteriovenous grafts in a novel baboon model. Ultrasound was used to monitor flow rates and vascular diameters throughout the study. Intimal hyperplasia in the outflow vein of TEVGs was assessed at the anastomosis and at juxta-anastomotic regions via histological analysis, and was compared to intimal hyperplasia with polytetrafluoroethylene (PTFE) grafts in the baboon model and in literature reports from other animal models. Less venous intimal hyperplasia was observed in histological sections with arteriovenous TEVGs than with arteriovenous PTFE grafts. TEVGs were associated with a mild, noninflammatory intimal hyperplasia. The extent of intimal tissue that formed with TEVG placement correlated with the rate of blood flow through tissue engineered vascular grafts at 2 weeks postimplant. Outflow vein dilatation was observed with increased flow rate. Both mid-graft flow rates and outflow vein diameters reached a plateau by week 4, which suggested that venous remodeling and intimal hyperplasia largely occurred within the first 4 weeks of implant in the baboon model. Given their compliant and noninflammatory nature, TEVGs appear resistant to triggers for venous intimal hyperplasia that are common for PTFE arteriovenous grafts, including (1) abundant proinflammatory macrophage populations that are associated with PTFE grafts and (2) compliance mismatch between PTFE grafts and the outflow vein. Our findings suggest that arteriovenous TEVGs develop only a mild form of venous intimal hyperplasia, which results from the typical hemodynamic changes that are associated with arteriovenous settings.

Duke Scholars

Published In

J Cardiovasc Transl Res

DOI

EISSN

1937-5395

Publication Date

October 2011

Volume

4

Issue

5

Start / End Page

674 / 682

Location

United States

Related Subject Headings

  • Tunica Intima
  • Tissue Engineering
  • Humans
  • Graft Occlusion, Vascular
  • Cell Proliferation
  • Blood Vessel Prosthesis Implantation
  • Blood Vessel Prosthesis
  • Arteriovenous Shunt, Surgical
  • Animals
 

Citation

APA
Chicago
ICMJE
MLA
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Prichard, H. L., Manson, R. J., DiBernardo, L., Niklason, L. E., Lawson, J. H., & Dahl, S. L. M. (2011). An early study on the mechanisms that allow tissue-engineered vascular grafts to resist intimal hyperplasia. J Cardiovasc Transl Res, 4(5), 674–682. https://doi.org/10.1007/s12265-011-9306-y
Prichard, Heather L., Roberto J. Manson, Louis DiBernardo, Laura E. Niklason, Jeffrey H. Lawson, and Shannon L. M. Dahl. “An early study on the mechanisms that allow tissue-engineered vascular grafts to resist intimal hyperplasia.J Cardiovasc Transl Res 4, no. 5 (October 2011): 674–82. https://doi.org/10.1007/s12265-011-9306-y.
Prichard HL, Manson RJ, DiBernardo L, Niklason LE, Lawson JH, Dahl SLM. An early study on the mechanisms that allow tissue-engineered vascular grafts to resist intimal hyperplasia. J Cardiovasc Transl Res. 2011 Oct;4(5):674–82.
Prichard, Heather L., et al. “An early study on the mechanisms that allow tissue-engineered vascular grafts to resist intimal hyperplasia.J Cardiovasc Transl Res, vol. 4, no. 5, Oct. 2011, pp. 674–82. Pubmed, doi:10.1007/s12265-011-9306-y.
Prichard HL, Manson RJ, DiBernardo L, Niklason LE, Lawson JH, Dahl SLM. An early study on the mechanisms that allow tissue-engineered vascular grafts to resist intimal hyperplasia. J Cardiovasc Transl Res. 2011 Oct;4(5):674–682.
Journal cover image

Published In

J Cardiovasc Transl Res

DOI

EISSN

1937-5395

Publication Date

October 2011

Volume

4

Issue

5

Start / End Page

674 / 682

Location

United States

Related Subject Headings

  • Tunica Intima
  • Tissue Engineering
  • Humans
  • Graft Occlusion, Vascular
  • Cell Proliferation
  • Blood Vessel Prosthesis Implantation
  • Blood Vessel Prosthesis
  • Arteriovenous Shunt, Surgical
  • Animals