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

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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.

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Acknowledgments

This work was supported in part by a Grant-in-aid for scientific research from the Japan Society for the Promotion of Science. The authors express their appreciation to Katsuhiko Oda for his advice during the experiments, Ayako Ono for her superb technical support in performing the animal experiments, and Ichiro Tsuji for his advice on the statistical analysis.

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryocho, Aoba-ku, Sendai, 980-8574, Japan

    Atsuhiko Sato, Shunsuke Kawamoto, Yusuke Suzuki, Goro Takahashi, Naoki Masaki, Kiichiro Kumagai, Koichi Tabayashi & Yoshikatsu Saiki

  2. Department of Diagnostic Pathology, Graduate School of Medicine, Tohoku University, Sendai, Japan

    Mika Watanabe

  3. Department of Medical Engineering and Cardiology, Tohoku University, Sendai, Japan

    Yoshifumi Saijo

Authors
  1. Atsuhiko Sato
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  2. Shunsuke Kawamoto
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Correspondence to Shunsuke Kawamoto.

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All of the authors declare that they had no competing interests related to this study.

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Sato, A., Kawamoto, S., Watanabe, M. et al. A novel biodegradable external mesh stent improved long-term patency of vein grafts by inhibiting intimal–medial hyperplasia in an experimental canine model. Gen Thorac Cardiovasc Surg 64, 1–9 (2016). https://doi.org/10.1007/s11748-015-0591-2

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