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葛 劲, 朱 臣, 翁 诚, 袁 丁. [Establishment and Validation of an Animal Model of Abdominal Aortic Aneurysm in Beagles Through Vascular Patch Angioplasty and Elastase Infusion]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:1276-1282. [PMID: 38162059 PMCID: PMC10752763 DOI: 10.12182/20231160205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Indexed: 01/03/2024]
Abstract
Objective To evaluate the effect of an abdominal aortic aneurysm (AAA) animal model established in beagles by way of vascular patch angioplasty combined with elastase infusion. Methods A total of 60 beagle dogs were included in this study. Among them, 10 beagles were assigned to a control group to obtain normal abdominal aortic wall tissue, while the other 50 underwent vascular patch angioplasty combined with elastase infusion in order to establish the AAA disease model. In order to evaluate the outcome of modeling, abdominal vascular ultrasonography was performed 14 days after the modeling surgery was performed and ultrasound and computed tomographic angiography (CTA) were performed 28 days after the modeling surgery. The criterion for evaluating modeling success is that the maximum diameter of the abdominal aortic aneurysm is 50% greater than the diameter of the normal abdominal aorta below the renal artery. A total of 20 beagles of the modelling group and 5 control beagles were sacrificed 35 days after the modeling surgery and infrarenal abdominal aortic wall tissues were harvested. Then, hematoxylin and eosin (H&E) staining, Masson's trichrome staining, and elastic van Gieson (EVG) staining were conducted to observe the pathology features of abdominal aortic wall tissues. Results A total of 50 beagles underwent the AAA modeling procedures, with the average operative and anesthesia time being (119.4±18.9) and (137.4±15.8) minutes, respectively, the average blood loss volume being (43.6±7.7) mL, the average abdominal aorta block time being (39.7±5.3) minutes during the modeling surgery, and the average abdominal aorta diameter measured during the surgery being (6.5±0.4) mm. Intraoperative mortality was 0%. Mortality within 30 days after the surgery was 2% (1 out of the 50 beagles). Postoperative ultrasound and CTA results revealed that the success rate of AAA modeling was 100%. Pathology examination suggested that the animal model rather successfully simulated the pathophysiologic changes associated with human AAA in regard to the morphological and pathological changes. Conclusion Vascular patch angioplasty combined with elastase infusion can be used to successfully establish AAA model in beagles. The AAA modeling method described in our report demonstrates stability and reliability in aneurysm formation effect and the surgical procedures are easy to replicate. The method integrates the advantages of previous animal modeling methods and can be used to study the pathogenesis of AAA.
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Affiliation(s)
- 劲廷 葛
- 四川大学华西医院 普外科 血管外科病房 (成都 610041)Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 臣谋 朱
- 四川大学华西医院 普外科 血管外科病房 (成都 610041)Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 诚馨 翁
- 四川大学华西医院 普外科 血管外科病房 (成都 610041)Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 丁 袁
- 四川大学华西医院 普外科 血管外科病房 (成都 610041)Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Vahabli E, Mann J, Heidari BS, Lawrence‐Brown M, Norman P, Jansen S, Pardo EDJ, Doyle B. The Technological Advancement to Engineer Next-Generation Stent-Grafts: Design, Material, and Fabrication Techniques. Adv Healthc Mater 2022; 11:e2200271. [PMID: 35481675 DOI: 10.1002/adhm.202200271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/04/2022] [Indexed: 12/12/2022]
Abstract
Endovascular treatment of aortic disorders has gained wide acceptance due to reduced physiological burden to the patient compared to open surgery, and ongoing stent-graft evolution has made aortic repair an option for patients with more complex anatomies. To date, commercial stent-grafts are typically developed from established production techniques with simple design structures and limited material ranges. Despite the numerous updated versions of stent-grafts by manufacturers, the reoccurrence of device-related complications raises questions about whether the current manfacturing methods are technically able to eliminate these problems. The technology trend to produce efficient medical devices, including stent-grafts and all similar implants, should eventually change direction to advanced manufacturing techniques. It is expected that through recent advancements, especially the emergence of 4D-printing and smart materials, unprecedented features can be defined for cardiovascular medical implants, like shape change and remote battery-free self-monitoring. 4D-printing technology promises adaptive functionality, a highly desirable feature enabling printed cardiovascular implants to physically transform with time to perform a programmed task. This review provides a thorough assessment of the established technologies for existing stent-grafts and provides technical commentaries on known failure modes. They then discuss the future of advanced technologies and the efforts needed to produce next-generation endovascular implants.
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Affiliation(s)
- Ebrahim Vahabli
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
| | - James Mann
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
| | - Behzad Shiroud Heidari
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies University of Western Australia Perth 6009 Australia
| | | | - Paul Norman
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- Medical School The University of Western Australia Perth 6009 Australia
| | - Shirley Jansen
- Curtin Medical School Curtin University Perth WA 6102 Australia
- Department of Vascular and Endovascular Surgery Sir Charles Gairdner Hospital Perth WA 6009 Australia
- Heart and Vascular Research Institute Harry Perkins Medical Research Institute Perth WA 6009 Australia
| | - Elena de Juan Pardo
- School of Engineering The University of Western Australia Perth 6009 Australia
- School of Mechanical Medical and Process Engineering Queensland University of Technology Brisbane Queensland 4059 Australia
- T3mPLATE Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth WA 6009 Australia
| | - Barry Doyle
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies University of Western Australia Perth 6009 Australia
- British Heart Foundation Centre for Cardiovascular Science The University of Edinburgh Edinburgh EH16 4TJ UK
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Chang C, Ginn B, Livingston NK, Yao Z, Slavin B, King MW, Chung S, Mao HQ. Medical Fibers and Biotextiles. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Animal Models Used to Explore Abdominal Aortic Aneurysms: A Systematic Review. Eur J Vasc Endovasc Surg 2016; 52:487-499. [DOI: 10.1016/j.ejvs.2016.07.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 07/01/2016] [Indexed: 01/09/2023]
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Nguyen TY, Cipriano AF, Guan RG, Zhao ZY, Liu H. In vitro interactions of blood, platelet, and fibroblast with biodegradable magnesium-zinc-strontium alloys. J Biomed Mater Res A 2015; 103:2974-86. [PMID: 25690931 DOI: 10.1002/jbm.a.35429] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/08/2022]
Abstract
Magnesium (Mg) alloy is an attractive class of metallic biomaterial for cardiovascular applications due to its biodegradability and mechanical properties. In this study, we investigated the degradation in blood, thrombogenicity, and cytocompatibility of Magnesium-Zinc-Strontium (Mg-Zn-Sr) alloys, specifically four Mg-4 wt % Zn-xSr (x = 0.15, 0.5, 1, and 1.5 wt %) alloys, together with pure Mg control and relevant reference materials for cardiovascular applications. Human whole blood and platelet rich plasma (PRP) were used as the incubation media to investigate the degradation behavior of the Mg-Zn-Sr alloys. The results showed that the PRP had a greater pH increase and greater concentration of Mg(2+) ions when compared with whole blood after 2 h of incubation with the same respective Mg alloys, suggesting that the Mg alloys degraded faster in PRP than in whole blood. The Mg alloy with 4 wt % Zn and 0.15 wt % Sr (named as ZSr41A) was identified as the most promising alloy for cardiovascular stent applications, because it showed slower degradation and less thrombogenicity, as indicated by the lower concentrations of Mg(2+) ions released and less deposition of platelets. Additionally, ZSr41 alloys were cytocompatible with fibroblasts in direct exposure culture in which the cells adhered and proliferated around the samples, with no statistical difference in cell adhesion density compared with the blank reference. Future studies on the ZSr41 alloys are necessary to investigate their direct interactions with other important cells in cardiovascular system, such as vascular endothelial cells and smooth muscle cells.
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Affiliation(s)
- T Y Nguyen
- Department of Bioengineering, University of California at Riverside, 900 University Avenue, Riverside, California, 92521
| | - A F Cipriano
- Department of Bioengineering, University of California at Riverside, 900 University Avenue, Riverside, California, 92521.,Materials Science and Engineering Program, University of California at Riverside, 900 University Avenue, Riverside, California, 92521
| | - Ren-Guo Guan
- School of Materials and Metallurgy, Northeastern University, Shenyang, 110004, China
| | - Zhan-Yong Zhao
- School of Materials and Metallurgy, Northeastern University, Shenyang, 110004, China
| | - Huinan Liu
- Department of Bioengineering, University of California at Riverside, 900 University Avenue, Riverside, California, 92521.,Materials Science and Engineering Program, University of California at Riverside, 900 University Avenue, Riverside, California, 92521
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Guidoin R, Zhang Z, Douville Y, Nutley M. Commentary: nitinol stent designs need to adhere to the 3Bs: biofunctionality, biodurability, and biocompatibility. J Endovasc Ther 2014; 21:240-2. [PMID: 24754283 DOI: 10.1583/13-4530c.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Robert Guidoin
- 1 Department of Surgery, Laval University, Quebec, Canada
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Medical Fibers and Biotextiles. Biomater Sci 2013. [DOI: 10.1016/b978-0-08-087780-8.00029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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Kim HB, Choi YH, So YH, Min SK, Kim HC, Kim YI, Park JH, Chung JW. Tissue responses to endovascular stent grafts for saccular abdominal aortic aneurysms in a canine model. J Korean Med Sci 2012; 27:1170-6. [PMID: 23091313 PMCID: PMC3468752 DOI: 10.3346/jkms.2012.27.10.1170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 08/14/2012] [Indexed: 11/20/2022] Open
Abstract
We investigated tissue responses to endoskeleton stent grafts for saccular abdominal aortic aneurysms (AAAs) in canines. Saccular AAAs were made with Dacron patch in 8 dogs, and were excluded by endoskeleton stent grafts composed of nitinol stent and expanded polytetrafluoroethylene graft. Animals were sacrificed at 2 months (Group 1; n = 3) or 6 months (Group 2; n = 5) after the placement, respectively. The aortas embedding stent grafts were excised en bloc for gross inspection and sliced at 5 to 8 mm intervals for histopathologic evaluation. Stent grafts were patent in all except a dog showing a thrombotic occlusion in Group 2. In the 7 dogs with patent lumen, the graft overhanging the saccular aneurysm was covered by thick or thin thrombi with no endothelial layer, and the graft over the aortic wall was completely covered by neointima with an endothelial layer. Transgraft cell migration was less active at an aneurysm than at adjacent normal aorta. In conclusion, endoskeleton stent grafts over saccular aneurysms show no endothelial coverage and poor transgraft cell migration in a canine model.
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Affiliation(s)
- Hyun Beom Kim
- Department of Radiology, National Cancer Center, Goyang, Korea
| | - Young Ho Choi
- Department of Radiology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Young Ho So
- Department of Radiology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo-Cheol Kim
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul, Korea
| | - Young Il Kim
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul, Korea
| | - Jae Hyung Park
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul, Korea
| | - Jin Wook Chung
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul, Korea
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Guidoin R, Douville Y, Clavel MA, Zhang Z, Nutley M, Pîbarot P, Dionne G. The marvel of percutaneous cardiovascular devices in the elderly. Ann N Y Acad Sci 2010; 1197:188-99. [DOI: 10.1111/j.1749-6632.2010.05517.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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AAA stent-grafts: past problems and future prospects. Ann Biomed Eng 2010; 38:1259-75. [PMID: 20162359 DOI: 10.1007/s10439-010-9953-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 01/31/2010] [Indexed: 10/19/2022]
Abstract
Endovascular aneurysm repair (EVAR) has quickly gained popularity for infrarenal abdominal aortic aneurysm repair during the last two decades. The improvement of available EVAR devices is critical for the advancement of patient care in vascular surgery. Problems are still associated with the grafts, many of which can necessitate the conversion of the patient to open repair, or even result in rupture of the aneurysm. This review attempts to address these problems, by highlighting why they occur and what the failings of the currently available stent grafts are, respectively. In addition, the review gives critical appraisal as to the novel methods required for dealing with these problems and identifies the new generation of stent grafts that are being or need to be designed and constructed in order to overcome the issues that are associated with the existing first- and second-generation devices.
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Zhao H, Wang L, Li Y, Liu X, King MW. The Mathematical Model for Evaluating Fatigue Resistance of SG Tubular Fabric: Relationship between Textile Parameters and Fatigue Performance. J Biomater Appl 2008; 24:579-90. [DOI: 10.1177/0885328208099437] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fatigue testing for twelve SG tubular fabrics with various textile parameters was performed under pulsatile pressure by an Accelerated fatigue tester. Two time points as of 0, and 1 × 108 cycles were selected. The percentage change of tubular diameter, fabric count, porosity, and water permeability before and after the fatigue testing were used to characterize the fatigue performance. Bursting work was used to indicate fatigue. The mathematical model of quantification theory I was used to analyze the influence of various textile parameters on the fatigue performance of SG tubular fabric. It was found that with the increase of fatigue time, bursting work decreased, and the predicting results by quantification theory I for the fatigue resistance were relatively accurate and the contribution ratio of each textile parameter to the fatigue performance was also obtained. Different textile parameter has different contribution ratio if different parameters were used to characterize the fatigue performance. Woven construction had more influence than yarn size on the fatigue performance, and yarn type had the least influence on it. Woven construction, yarn size, and yarn type had interactive influence on the fatigue performance. This can provide theoretical foundation for making better fatigue resistant SG tubular fabrics.
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Affiliation(s)
- Huijing Zhao
- Key Lab of Textile Science and Technology, Ministry of Education College of Textiles, Donghua University, Shanghai, 201620
| | - Lu Wang
- Key Lab of Textile Science and Technology, Ministry of Education College of Textiles, Donghua University, Shanghai, 201620,
| | - Yuling Li
- Key Lab of Textile Science and Technology, Ministry of Education College of Textiles, Donghua University, Shanghai, 201620
| | - Xiaoyan Liu
- Key Lab of Textile Science and Technology, Ministry of Education College of Textiles, Donghua University, Shanghai, 201620
| | - Martin W. King
- Key Lab of Textile Science and Technology, Ministry of Education College of Textiles, Donghua University, Shanghai, 201620, College of Textiles, North Carolina State University, Raleigh 27695, USA
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Guidoin R, Peirano MAM, Barone HD, Douville Y, Zhang Z, Guzman R, Bertoni H, Merhi Y, Marinov GR, McGregor R, Zhang H, Chappard D, Dionne G, Deng X. Transrenal deployment of a modular stent graft to repair AAAs with short necks: experiments in dogs. ACTA ACUST UNITED AC 2008; 36:310-39. [PMID: 18649168 DOI: 10.1080/10731190802239016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Severely angulated (> 60 degrees ) or short (< 15 mm) proximal necks remain significant anatomical limitations for endovascular stent-graft repairs for abdominal aortic aneurysms. Ensuring proper proximal fixation of the stent-graft to the host artery without the short-or long-term risks of endoleak or migration represents a particular technical challenge for these anatomical circumstances. An innovative balloon expandable stent combined with a weft-knitted prosthesis was specifically designed for these situations by modelling the stent to the neck anatomy without overdistension or potential barotrauma allowing better incorporation of the device. The Latecba stent-graft consists of a 2 parts modular design. The first one, Module A, is deployed at the transrenal level and consists of a Palmaz type stent whose first half is bare and second half is sutured to a crimped weft-knitted polyester graft whose distal end holds a constriction. The second Module B is a non-crimped weft-knitted graft attached to 2 stainless steel stents. The first stent is entirely contained in the proximal textile tube, allowing fixation to module A. The second stent, which is left uncovered over the distal third, ensures proper fixation of the stent-graft distally. Following the creation of a prosthetic aneurysm in the infrarenal aorta in 32 dogs, 29 received the Latecba stent-graft for scheduled durations of 10 days, 1 month, 3 months and 6 months. Proper deployment of the stent-grafts was achieved without difficulty. All 29 animals survived and the devices were all patent at sacrifice. No device defects or migrations were observed and the stent-grafts proved to be efficient in this setting to exclude the aneurysm. Analyses of the explanted devices (gross observations, RX, CT scan, IVUS, angioscopy) confirmed the stability of this modular stent-graft. Further on-going clinical investigations are warranted to validate this concept before this stent-graft becomes commercially available without any restriction.
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Affiliation(s)
- Robert Guidoin
- Quebec Biomaterials Institute, CHUQ and Department of Surgery, Laval University, Quebec, Canada.
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