The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 6 , Pages 1237-1246 , June 2008

A novel bioengineered small-caliber vascular graft incorporating heparin and sirolimus: Excellent 6-month patency

  • Yosuke Ishii, MD

      Affiliations

    • Washington University School of Medicine, Barnes-Jewish Hospital, Division of Cardiothoracic Surgery, St Louis, Mo
  • ,
  • Shun-ichiro Sakamoto, MD

      Affiliations

    • Washington University School of Medicine, Barnes-Jewish Hospital, Division of Cardiothoracic Surgery, St Louis, Mo
  • ,
  • Russell T. Kronengold, PhD

      Affiliations

    • Kensey Nash Corporation, Exton, Pa
  • ,
  • Renu Virmani, MD

      Affiliations

    • American Registry of Pathology, Washington DC
  • ,
  • Elias A. Rivera, MHS

      Affiliations

    • American Registry of Pathology, Washington DC
  • ,
  • Scott M. Goldman, MS

      Affiliations

    • Washington University School of Medicine, Barnes-Jewish Hospital, Division of Cardiothoracic Surgery, St Louis, Mo
  • ,
  • Ericka J. Prechtel, MS

      Affiliations

    • Kensey Nash Corporation, Exton, Pa
  • ,
  • James G. Hill, MS

      Affiliations

    • Kensey Nash Corporation, Exton, Pa
  • ,
  • Ralph J. Damiano Jr., MD

      Affiliations

    • Washington University School of Medicine, Barnes-Jewish Hospital, Division of Cardiothoracic Surgery, St Louis, Mo
    • Corresponding Author InformationAddress for reprints: Ralph J. Damiano Jr, MD, Suite 3108, Queeny Tower, Barnes-Jewish Hospital Plaza. St Louis, MO 63110.

Received 16 May 2007 ,Revised 4 September 2007 ,Accepted 17 September 2007.

References 

  1. Savage EB, Grab JD, O'Brien SM, et al. Use of both internal thoracic arteries in diabetic patients increases deep sternal wound infection. Ann Thorac Surg. 2007;83:1002–1006
  2. Angelini GD, Newby AC. The future of saphenous vein as a coronary artery bypass conduit. Eur Heart J. 1989;10:273–280
  3. Cameron A, Davis KB, Green G, Schaff HV. Coronary bypass surgery with internal-thoracic-artery grafts—effects on survival over a 15-year period. N Engl J Med. 1996;334:216–219
  4. Loop FD, Lytle BW, Cosgrove DM, Stewart RW, Goormastic M, Williams GW, et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med. 1986;314:1–6
  5. Ehsan A, Mann MJ, Dell'Acqua G, Tamura K, Braun-Dullaeus R, Dzau VJ. Endothelial healing in vein grafts: proliferative burst unimpaired by genetic therapy of neointimal disease. Circulation. 2002;105:1686–1692
  6. Ishii Y, Kronengold RT, Virmani R, Rivera EA, Goldman SM, Prechtel EJ, et al. Novel bioengineered small caliber vascular graft with excellent one-month patency. Ann Thorac Surg. 2006;83:517–525
  7. Walpoth BH, Rogulenko R, Tikhvinskaia E, Gogolewski S, Schaffner T, Hess OM, et al. Improvement of patency rate in heparin-coated small synthetic vascular grafts. Circulation. 1998;98(19 Suppl):II319–II323
  8. Lin PH, Chen C, Bush RL, Yao Q, Lumsden AB, Hanson SR. Small-caliber heparin-coated ePTFE grafts reduce platelet deposition and neointimal hyperplasia in a baboon model. J Vasc Surg. 2004;39:1322–1328
  9. Marx SO, Jayaraman T, Go LO, Marks AR. Rapamycin-FKBP inhibits cell cycle regulators of proliferation in vascular smooth muscle cells. Circ Res. 1995;76:412–417
  10. Burke SE, Lubbers NL, Chen YW, Hsieh GC, Mollison KW, Luly JR, et al. Neointimal formation after balloon-induced vascular injury in Yucatan minipigs is reduced by oral rapamycin. J Cardiovasc Pharmacol. 1999;33:829–835
  11. Gallo R, Padurean A, Jayaraman T, Marx S, Roque M, Adelman S, et al. Inhibition of intimal thickening after balloon angioplasty in porcine coronary arteries by targeting regulators of the cell cycle. Circulation. 1999;99:2164–2170
  12. Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, et al. Randomized study with the sirolimus-coated bx velocity balloon-expandable stent in the treatment of patients with de novo native coronary artery lesions. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346:1773–1780
  13. Jones DN, Rutherford RB, Ikezawa T, Nishikimi N, Ishibashi H, Whitehill TA. Factors affecting the patency of small-caliber prostheses: observations in a suitable canine model. J Vasc Surg. 1991;14:441–448
  14. Esquivel CO, Blaisdell FW. Why small caliber vascular grafts fail: a review of clinical and experimental experience and the significance of the interaction of blood at the interface. J Surg Res. 1986;41:1–15
  15. Pasic M, Muller-Glauser W, von Segesser LK, Lachat M, Mihaljevic T, Turina MI. Superior late patency of small-diameter Dacron grafts seeded with omental microvascular cells: an experimental study. Ann Thorac Surg. 1994;58:677–683
  16. Laube HR, Duwe J, Rutsch W, Konertz W. Clinical experience with autologous endothelial cell-seeded polytetrafluoroethylene coronary artery bypass grafts. J Thorac Cardiovasc Surg. 2000;120:134–141
  17. Arts CH, Blankensteijn JD, Heijnen-Snyder GJ, Verhagen HJ, Hedeman Joosten PP, Sixma JJ, et al. Reduction of non-endothelial cell contamination of microvascular endothelial cell seeded grafts decreases thrombogenicity and intimal hyperplasia. Eur J Vasc Endovasc Surg. 2002;23:404–412
  18. Hsu SH, Chuang SC, Chen CH, Chen DC. Endothelial cell attachment to the gamma irradiated small diameter polyurethane vascular grafts. Biomed Mater Eng. 2006;16:397–404
  19. Sawyer P. Modern Vascular Grafts. New York: McGraw-Hill, Inc; 1987;326
  20. Conklin BS, Richter ER, Kreutziger KL, Zhong DS, Chen C. Development and evaluation of a novel decellularized vascular xenograft. Med Eng Phys. 2002;24:173–183
  21. Greisler HP. Arterial regeneration over absorbable prostheses. Arch Surg. 1982;117:1425–1431

 Research supported by the NIST Advanced Technology program (Award 70NANB1H3032). Russell Kronengold and Scott Goldman report equity ownership in and are employees of Kensey Nash Corporation.

 Presented at the American Association of Thoracic Surgery 87th Scientific Sessions, Washington DC, May, 2007.

PII: S0022-5223(07)01998-8

doi: 10.1016/j.jtcvs.2007.09.077

The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 6 , Pages 1237-1246 , June 2008