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Novel Bioresorbable Vascular Graft With Sponge-Type Scaffold as a Small-Diameter Arterial Graft
Tadahisa Sugiura, MD, PhD, Shuhei Tara, MD, PhD, Hidetaka Nakayama, PhD, Hirotsugu Kurobe, MD, PhD, Tai Yi, MD, Yong-Ung Lee, PhD, Avione Y. Lee, PhD, Christopher K. Breuer, MD, Toshiharu Shinoka, MD, PhD The Annals of Thoracic Surgery Volume 102, Issue 3, Pages (September 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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Fig 1 Representative scanning electron microscopy images of the grafts. Top Row: high magnification of small-pore and large-pore grafts. Bottom Row: low magnification of small-pore and large-pore grafts. The scaffolds were constructed by pouring a solution of poly(1-lactide-co-ε-caprolactone) (PLCL) into a hollow glass tube, followed by freeze-drying under a vacuum. Pore sizes were adjusted to small pores (12.8 ± 1.85 μm) and large pores (28.5 ± 5.25 μm). These scaffolds were reinforced by poly (1-lactic acid) nanofiber, which were made using electrospinning technology, with 40 μm thickness at the outer side of PLCL scaffold. Inner luminal diameters of each graft were ∼600 μm. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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Fig 2 (A) Scaffold cellular infiltration at 8 weeks after implantation. Hematoxylin and eosin (HE) staining demonstrated dense cellular infiltration into the poly(1-lactide-co-ε-caprolactone) scaffold layer. (B) Nuclei were counted to obtain the number of infiltrated cells in the inner, middle, and outer layers of the scaffold. The large-pore group indicated higher cell numbers in all layers, although there was no statistical difference. Neither (C) luminal diameter nor (D) wall thickness differed between groups. The error bars show the standard deviation. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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Fig 3 Histologic analysis of the grafts at 8 weeks after implantation. (A) Masson’s Trichrome and Hart’s staining showed collagen and elastin deposition in the neointima, respectively. Visualization of picrosirius red staining with polarized light microscopy was used to evaluate the deposition of thin (type III; green) to thick (type I; yellow) collagen fibers in each group. (B) Higher deposition of both collagen I and III were observed in the inner and middle scaffold layers of the large-pore group, although there was no statistical difference between the groups in the distribution of collagen type I or type III. (C) Endothelialization of the grafts at 8 weeks after implantation. Representative immunofluorescent images of endothelial cell (CD31) and α-smooth muscle actin (SMA) staining. Endothelial cell coverage on the luminal surface of the graft with smooth muscle cells surrounding them was observed in both groups equally. (D) Gene expression was analyzed by reverse transcription quantitative polymerase chain reaction using the ΔΔCT method. There was no statistical difference of relative expression of platelet endothelial cell adhesion molecule-1 (PECAM) or endothelial nitric oxide synthase (eNOS) in explanted grafts between the groups. The error bars show the standard deviation. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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Fig 4 Macrophage infiltration of the grafts 8 weeks after implantation was evaluated by histologic assessment. (A) Representative images of immunohistochemical staining of F4/80 (entire macrophage), inducible nitric oxide synthase (iNOS; M1 macrophage), and CD206 (M2 macrophage). (B) The number of M1 and M2 macrophage, defined by iNOS and CD206, respectively, showed no significant difference between the groups. The error bars show the standard deviation. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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