Tissue-engineered stent-graft integrates with aortic wall by recruiting host tissue into graft scaffold Mugiho Takeuchi, MD, Toru Kuratani, MD, PhD,

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Presentation transcript:

Tissue-engineered stent-graft integrates with aortic wall by recruiting host tissue into graft scaffold Mugiho Takeuchi, MD, Toru Kuratani, MD, PhD, Shigeru Miyagawa, MD, PhD, Yukitoshi Shirakawa, MD, PhD, Kazuo Shimamura, MD, Keiwa Kin, MD, Takuya Yoshida, MD, Yoshio Arai, MD, PhD, Takaya Hoashi, MD, Noboru Teramoto, PhD, Koichiro Hirakawa, MS, Naomasa Kawaguchi, PhD, Yoshiki Sawa, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 148, Issue 4, Pages 1719-1725 (October 2014) DOI: 10.1016/j.jtcvs.2014.04.003 Copyright © 2014 Terms and Conditions

Figure 1 A, Composition of the new stent-graft using the polyethylene terephthalate (PET)/polyglycolic acid (PGA) graft and a self-expanding stainless Z stent. The PET/PGA graft was woven with a double-layered yarn compound with the PET and PGA filaments as the warp and a thread of PET fibers as the woof. B, High magnification of the double-layered warp yarn. The core of the yarn was composed of a mixture of PET and PGA filaments, and slack loops of the PGA filaments formed the outer sheath. C, Delivery system of the stent-graft. The inner dilator of the 18F Keller-Timmermann Introducer Sheath (KTI) (Cook Medical, Inc) was curved such that it could contain the stent-graft under the outer sheath. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 1719-1725DOI: (10.1016/j.jtcvs.2014.04.003) Copyright © 2014 Terms and Conditions

Figure 2 Comparative evaluation of the mechanical properties between the polyethylene terephthalate (PET)/polyglycolic acid (PGA) graft and a thin-walled woven polyester graft. A, Tensile strength. B, Water permeability. The dashed line indicates measurement sensitivity. C, Flexibility evaluated using the KES-FB2-AUTO-A (KES) (Kato Tech Co, Ltd) pure bending test. D, Assessment of the temporal durability of the PET/PGA graft using the accelerating aging test. N.S., Not significant. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 1719-1725DOI: (10.1016/j.jtcvs.2014.04.003) Copyright © 2014 Terms and Conditions

Figure 3 Evaluation of the adhesion strength between the 2 grafts and the native aortic wall at 2 months after implantation. PET/PGA, Polyethylene terephthalate/polyglycolic acid. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 1719-1725DOI: (10.1016/j.jtcvs.2014.04.003) Copyright © 2014 Terms and Conditions

Figure 4 Macroscopic appearance of the luminal surface of the 2 grafts at 2 months after implantation (scale bar 5 mm). PET/PGA, Polyethylene terephthalate/polyglycolic acid. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 1719-1725DOI: (10.1016/j.jtcvs.2014.04.003) Copyright © 2014 Terms and Conditions

Figure 5 A, Histologic evaluation of the explants at 2 months after implantation. Upper, Polyethylene terephthalate (PET)/polyglycolic acid (PGA) graft. Lower, Thin-walled woven polyester graft, stained with left, hematoxylin-eosin (HE) and Victoria blue (VB), middle, α-smooth muscle actin (α-SMA), and right, von Willebrand factor (vWF) (original magnification, ×100; scale bar, 100 μm). †Layer of the neointima that contains the graft. ‡Native aortic wall. B, Highly magnified image of the graft in the explant with α-SMA staining to show cell infiltration into the graft. Left, PET/PGA graft (original magnification, ×200; scale bar, 100 μm). Right, Thin-walled woven polyester graft (original magnification, ×400; scale bar, 50 μm). The luminal side is oriented to the upper side in every A and B figure. C, The cell counts, expressed as the mean number of cells/mm2, in the graft. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 1719-1725DOI: (10.1016/j.jtcvs.2014.04.003) Copyright © 2014 Terms and Conditions