Inhibition of neointimal hyperplasia in a sheep model of dialysis access failure with the bioabsorbable Vascular Wrap⁎ paclitaxel-eluting mesh Ted R.

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Inhibition of neointimal hyperplasia in a sheep model of dialysis access failure with the bioabsorbable Vascular Wrap⁎ paclitaxel-eluting mesh Ted R. Kohler, MD, MSc, Philip M. Toleikis, PhD, David M. Gravett, PhD, Rui L. Avelar, MD Journal of Vascular Surgery Volume 45, Issue 5, Pages 1029-1038.e3 (May 2007) DOI: 10.1016/j.jvs.2007.01.057 Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 1 Schematic diagram of right external jugular vein and expanded polytetrafluoroethylene (ePTFE) graft anastomosis with applied mesh and histologic sections. Journal of Vascular Surgery 2007 45, 1029-1038.e3DOI: (10.1016/j.jvs.2007.01.057) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 2 Example of a section through the toe of the graft (section 4) at low power showing where capillary density was measured in the neointima (bar represents 4 mm). The inset is a high power (bar represents 400 μm) from this region demonstrating multiple capillaries (arrow). Journal of Vascular Surgery 2007 45, 1029-1038.e3DOI: (10.1016/j.jvs.2007.01.057) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 3 In vitro drug elution curves (presented with mean ± standard deviation) for paclitaxel from the polyglycolic-polylactid acid mesh at the three concentrations used in this experiment, 0.3 (diamonds), 0.7 (squares), and 1.2 (triangles) μg/mm2. Journal of Vascular Surgery 2007 45, 1029-1038.e3DOI: (10.1016/j.jvs.2007.01.057) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 4 Dose effect of paclitaxel on neointimal area (presented with mean ± SEM). *P < .05 vs 0 mg mesh group; there was no neointima formation with the two highest-dose mesh groups in graft section 6. All P values reported are based on pair-wise comparisons made using the Wilcoxon rank sum test; the ranges of P values based on the Fligner-Policello test statistic are reported in Appendices B and C, online only. Journal of Vascular Surgery 2007 45, 1029-1038.e3DOI: (10.1016/j.jvs.2007.01.057) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 5 Left, Photomicrograph of a representative section 5 from the zero-dose mesh control and (right) 1.2 μg/mm2 paclitaxel mesh group (bar represents 4 mm). M, Mesh, G, ePTFE graft; N, neointima; T, thrombus; V, vein; and L, lumen. Journal of Vascular Surgery 2007 45, 1029-1038.e3DOI: (10.1016/j.jvs.2007.01.057) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions