Chronic in vitro shear stress stimulates endothelial cell retention on prosthetic vascular grafts and reduces subsequent in vivo neointimal thickness

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Presentation transcript:

Chronic in vitro shear stress stimulates endothelial cell retention on prosthetic vascular grafts and reduces subsequent in vivo neointimal thickness Alan Dardik, MD, PhD, Ailian Liu, MD, Barbara J. Ballermann, MD Journal of Vascular Surgery Volume 29, Issue 1, Pages 157-167 (January 1999) DOI: 10.1016/S0741-5214(99)70357-5 Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Light-microscopic appearance of endothelial cell–lined vascular grafts. Endothelial cell–seeded polyurethane graft treated with 25 dyne/cm2 mean shear stress (A) before implantation and (B) 24 hours after implantation in vivo. C, Endothelial cell–seeded polyurethane graft treated with 1 dyne/cm2 mean shear stress shown 24 hours after implantation in vivo. D, Gelatin-coated polyurethane graft without endothelial cells 24 hours after implantation in vivo. E and F, Polyurethane graft with shear stress (25 dyne/cm2) treated endothelial cells that were also transduced with Lac-Z adenovirus, shown 24 hours after implantation in vivo. Magnification: A to C and F, 100×; D, 40×; and E, 20×. Journal of Vascular Surgery 1999 29, 157-167DOI: (10.1016/S0741-5214(99)70357-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 A, Endothelial cell density on polyurethane vascular grafts treated with 0, 1, or 25 dyne/cm2 shear stress, before (hatched bars) and 24 hours after implantation in vivo (solid bars). B, Surgical hemostasis time after re-establishment of aortic circulation for unseeded grafts, seeded grafts not treated with shear stress, and seeded grafts treated with 1 or 25 dyne/cm2 shear stress. *P < .0001, Student t test. Journal of Vascular Surgery 1999 29, 157-167DOI: (10.1016/S0741-5214(99)70357-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Scanning electron microscopy of endothelial cell–seeded polyurethane grafts. Endothelial cell–seeded graft treated with 25 dyne/cm2 mean shear stress (A) before implantation and (B) 24 hours after implantation in vivo. C, Endothelial cell–seeded polyurethane graft treated with 1 dyne/cm2 mean shear stress shown 24 hours after implantation in vivo. Magnification, 420×. Journal of Vascular Surgery 1999 29, 157-167DOI: (10.1016/S0741-5214(99)70357-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Nature of intimal cell layer on polyurethane grafts 1 week and 3 months after implantation in vivo. Grafts were harvested 1 week (A to C) or 3 months (D to I) after implantation in vivo. A and D, Anti–von Willebrand's factor antibody to identify endothelial cells. B and E, Anti-α smooth muscle actin antibody to identify neointimal myofibroblasts or smooth muscle cells. C and F, EDI antibody to identify macrophages. Magnification: A to F, 160×. G to I, Polyurethane grafts 3 months after implantation in vivo. G, polyurethane graft neither coated with gelatin or seeded with endothelial cells. H, Endothelial cell–seeded polyurethane graft pretreated with 1 dyne/cm2 mean shear stress. I, Endothelial cell–seeded polyurethane graft pretreated with 25 dyne/ cm2 mean shear stress. Magnification: G to I, 64×. Journal of Vascular Surgery 1999 29, 157-167DOI: (10.1016/S0741-5214(99)70357-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Quantification of neointimal thickness 3 months after graft implantation. Mean thickness of neointimal layer, measured at 8 equidistant points around circumference of 3 to 6 cross-sections taken from midpoint of graft was: A, 158 ± 46 μm (n = 4) for grafts without endothelial cells; B, 60 ± 23 μm (n = 5) for endothelial cell–seeded grafts pretreated with 1 dyne/cm2; and C, 41 ± 12 μm (n = 4) for endothelial cell–seeded grafts pretreated with 25 dyne/cm2 shear stress. Journal of Vascular Surgery 1999 29, 157-167DOI: (10.1016/S0741-5214(99)70357-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions