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A Journal on Angiology
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
International Angiology 2000 September;19(3):259-269
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 L. Q. *, Du W. *, Li G. D. *, Wu J. D. *, Wang D. J. *, Sha R. Y. **
From the China Vascular Institute, First Affiliated Hospital, Zhejian University School of Medicine, Hangzhou, China
* Vascular Institute, General Post and Telecom Hospital, the 8th Clinical Medical College of the Beijing Medical University, Beijing, China
** Department of Pathology, Basic Sciences Institute, Chinese Academy of Medical Sciences, Beijing, China
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 μm and 302 μm, 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.