Comparison of the endothelialization of small intestinal submucosa, dacron, and expanded polytetrafluoroethylene suspended in the thoracoabdominal aorta in sheep

Kivilcim Yavuz, Serdar Geyik, Dusan Pavcnik, Barry Uchida, Christopher Corless, David E. Hartley, Ahmet Goktay, Luiz Otavio Correa, Hans Timmermans, Jason P. Hodde, John Kaufman, Frederick Keller, Josef Rosch

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

PURPOSE: This study was undertaken to evaluate and compare endothelialization of small intestinal submucosa (SIS), Dacron, and expanded polytetrafluoroethylene (ePTFE) in high-pressure flow without aortic wall contact and to evaluate the suitability of SIS as a vascular graft material. MATERIALS AND METHODS: In 12 adult sheep, three types of membrane leaflets of similar thickness (approximately 200 μm) were suspended within large square stents without contact with the thoracoabdominal aortic wall: SIS (n = 12), Dacron (n = 12), and ePTFE (n = 12). Each animal received one leaflet of each material. Aortograms were obtained before and after percutaneous implantation and when the animal was killed at 8 weeks (n = 6) or 18 weeks (n = 6). Cell coverage and remodeling of SIS, Dacron, and ePTFE membranes were assessed by gross and histologic microscopic examinations. RESULTS: Thirty-five successfully implanted leaflets were evaluated. SIS showed progressive remodeling. Thirty-three leaflets exhibited thickening as a result of neointimal formation and endothelialization, most likely from circulating endothelial cells. Dacron exhibited the greatest and most progressing degree of neointimal formation and endothelialization, followed by SIS and then ePTFE. With SIS and ePTFE, neointimal formation decreased with time, but endothelialization was stable. Uneven neointimal formation and endothelialization on the outer surfaces and distal leaflet positions were seen. CONCLUSIONS: SIS showed progressive remodeling with moderate and regressive neointimal formation and moderate stable endothelialization. Further study of its durability and incorporation into the aortic wall needs to be performed to evaluate its suitability as a cover for aortic endografts.

Original languageEnglish (US)
Pages (from-to)873-882
Number of pages10
JournalJournal of Vascular and Interventional Radiology
Volume17
Issue number5
DOIs
StatePublished - May 2006

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Polyethylene Terephthalates
Polytetrafluoroethylene
Aorta
Sheep
Membranes
Stents
Blood Vessels
Endothelial Cells
Transplants
Pressure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Comparison of the endothelialization of small intestinal submucosa, dacron, and expanded polytetrafluoroethylene suspended in the thoracoabdominal aorta in sheep. / Yavuz, Kivilcim; Geyik, Serdar; Pavcnik, Dusan; Uchida, Barry; Corless, Christopher; Hartley, David E.; Goktay, Ahmet; Correa, Luiz Otavio; Timmermans, Hans; Hodde, Jason P.; Kaufman, John; Keller, Frederick; Rosch, Josef.

In: Journal of Vascular and Interventional Radiology, Vol. 17, No. 5, 05.2006, p. 873-882.

Research output: Contribution to journalArticle

Yavuz, Kivilcim ; Geyik, Serdar ; Pavcnik, Dusan ; Uchida, Barry ; Corless, Christopher ; Hartley, David E. ; Goktay, Ahmet ; Correa, Luiz Otavio ; Timmermans, Hans ; Hodde, Jason P. ; Kaufman, John ; Keller, Frederick ; Rosch, Josef. / Comparison of the endothelialization of small intestinal submucosa, dacron, and expanded polytetrafluoroethylene suspended in the thoracoabdominal aorta in sheep. In: Journal of Vascular and Interventional Radiology. 2006 ; Vol. 17, No. 5. pp. 873-882.
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T1 - Comparison of the endothelialization of small intestinal submucosa, dacron, and expanded polytetrafluoroethylene suspended in the thoracoabdominal aorta in sheep

AU - Yavuz, Kivilcim

AU - Geyik, Serdar

AU - Pavcnik, Dusan

AU - Uchida, Barry

AU - Corless, Christopher

AU - Hartley, David E.

AU - Goktay, Ahmet

AU - Correa, Luiz Otavio

AU - Timmermans, Hans

AU - Hodde, Jason P.

AU - Kaufman, John

AU - Keller, Frederick

AU - Rosch, Josef

PY - 2006/5

Y1 - 2006/5

N2 - PURPOSE: This study was undertaken to evaluate and compare endothelialization of small intestinal submucosa (SIS), Dacron, and expanded polytetrafluoroethylene (ePTFE) in high-pressure flow without aortic wall contact and to evaluate the suitability of SIS as a vascular graft material. MATERIALS AND METHODS: In 12 adult sheep, three types of membrane leaflets of similar thickness (approximately 200 μm) were suspended within large square stents without contact with the thoracoabdominal aortic wall: SIS (n = 12), Dacron (n = 12), and ePTFE (n = 12). Each animal received one leaflet of each material. Aortograms were obtained before and after percutaneous implantation and when the animal was killed at 8 weeks (n = 6) or 18 weeks (n = 6). Cell coverage and remodeling of SIS, Dacron, and ePTFE membranes were assessed by gross and histologic microscopic examinations. RESULTS: Thirty-five successfully implanted leaflets were evaluated. SIS showed progressive remodeling. Thirty-three leaflets exhibited thickening as a result of neointimal formation and endothelialization, most likely from circulating endothelial cells. Dacron exhibited the greatest and most progressing degree of neointimal formation and endothelialization, followed by SIS and then ePTFE. With SIS and ePTFE, neointimal formation decreased with time, but endothelialization was stable. Uneven neointimal formation and endothelialization on the outer surfaces and distal leaflet positions were seen. CONCLUSIONS: SIS showed progressive remodeling with moderate and regressive neointimal formation and moderate stable endothelialization. Further study of its durability and incorporation into the aortic wall needs to be performed to evaluate its suitability as a cover for aortic endografts.

AB - PURPOSE: This study was undertaken to evaluate and compare endothelialization of small intestinal submucosa (SIS), Dacron, and expanded polytetrafluoroethylene (ePTFE) in high-pressure flow without aortic wall contact and to evaluate the suitability of SIS as a vascular graft material. MATERIALS AND METHODS: In 12 adult sheep, three types of membrane leaflets of similar thickness (approximately 200 μm) were suspended within large square stents without contact with the thoracoabdominal aortic wall: SIS (n = 12), Dacron (n = 12), and ePTFE (n = 12). Each animal received one leaflet of each material. Aortograms were obtained before and after percutaneous implantation and when the animal was killed at 8 weeks (n = 6) or 18 weeks (n = 6). Cell coverage and remodeling of SIS, Dacron, and ePTFE membranes were assessed by gross and histologic microscopic examinations. RESULTS: Thirty-five successfully implanted leaflets were evaluated. SIS showed progressive remodeling. Thirty-three leaflets exhibited thickening as a result of neointimal formation and endothelialization, most likely from circulating endothelial cells. Dacron exhibited the greatest and most progressing degree of neointimal formation and endothelialization, followed by SIS and then ePTFE. With SIS and ePTFE, neointimal formation decreased with time, but endothelialization was stable. Uneven neointimal formation and endothelialization on the outer surfaces and distal leaflet positions were seen. CONCLUSIONS: SIS showed progressive remodeling with moderate and regressive neointimal formation and moderate stable endothelialization. Further study of its durability and incorporation into the aortic wall needs to be performed to evaluate its suitability as a cover for aortic endografts.

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