A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig.
John JosephVito Domenico BrunoNadiah SulaimanAlexander WardThomas W JohnsonHelna Mary BabyPraveen Kerala VarmaRajesh JoseShantikumar V NairDeepthy MenonSarah Jane GeorgeRaimondo AscionePublished in: Journal of nanobiotechnology (2022)
Globally, millions of patients are affected by myocardial infarction or lower limb gangrene/amputation due to atherosclerosis. Available surgical treatment based on vein and synthetic grafts provides sub-optimal benefits. We engineered a highly flexible and mechanically robust nanotextile-based vascular graft (NanoGraft) by interweaving nanofibrous threads of poly-L-lactic acid to address the unmet need. The NanoGrafts were rendered impervious with selective fibrin deposition in the micropores by pre-clotting. The pre-clotted NanoGrafts (4 mm diameter) and ePTFE were implanted in a porcine carotid artery replacement model. The fibrin-laden porous milieu facilitated rapid endothelization by the transmural angiogenesis in the NanoGraft. In-vivo patency of NanoGrafts was 100% at 2- and 4-weeks, with no changes over time in lumen size, flow velocities, and minimal foreign-body inflammatory reaction. However, the patency of ePTFE at 2-week was 66% and showed marked infiltration, neointimal thickening, and poor host tissue integration. The study demonstrates the in-vivo feasibility and safety of a thin-layered vascular prosthesis, viz., NanoGraft, and its potential superiority over the commercial ePTFE.
Keyphrases
- lower limb
- lactic acid
- end stage renal disease
- endothelial cells
- ejection fraction
- newly diagnosed
- heart failure
- optic nerve
- peritoneal dialysis
- randomized controlled trial
- type diabetes
- clinical trial
- left ventricular
- tissue engineering
- gestational age
- patient reported outcomes
- reduced graphene oxide
- ultrasound guided
- atrial fibrillation
- optical coherence tomography
- solid state
- sensitive detection
- placebo controlled