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1.
Materials (Basel) ; 16(14)2023 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-37512188

RESUMO

In situ fenestration of endovascular stent-grafts has become a mainstream bailout technique to treat complex emergent aneurysms while maintaining native anatomical visceral and aortic arch blood supplies. Fabric tearing from creating the in situ fenestration using balloon angioplasty may extend beyond the intended diameter over time. Further tearing may result from the physiologic pulsatile motion at the branching site. A resultant endoleak at the fenestrated sites in stent-grafts could ultimately lead to re-pressurization of the aortic sac and, eventually, rupture. In an attempt to address this challenge, plain woven fabrics were designed. They hold a specific corona surrounding a square-shaped cluster with a plain weave fabric structure, a 2/2 twill, or a honeycomb. The corona was designed to stop potential further tearing of the fabric caused by the initial balloon angioplasty and stent or later post-implantation motion. The cluster within the corona was designed with relatively loose fabric structures (plain weave, 2/2 twill weave, and honeycomb) to facilitate the laser fenestration. Two commercial devices, Anaconda (Vascutek, Terumo Aortic) and Zenith TX2 (Cook), were selected as controls for comparison against this new design. All the specimens were characterized by morphology, thickness, and water permeability. The results demonstrated that all specimens with a low thickness and water permeability satisfied the requirements for a stent graft material that would be low profile and resistant to endoleaks. The in situ fenestrations were performed on all fabrics utilizing an Excimer laser followed by balloon angioplasty. The fabrics were further observed by light microscopy and scanning electron microscopy. The dimension of the fenestrated apertures was smaller than the balloon's diameter. The tearing was effectively confined within the corona. The clinical acceptability of this concept deserves additional bench testing and animal experimentation.

2.
Materials (Basel) ; 15(22)2022 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-36431403

RESUMO

This study explored the ideal period for wearing masks to prevent the physiological and psychological problems associated with long-term face mask use during respiratory infections by healthcare workers. Breathing simulators, surgical masks (SM) and medical respirators (PM) were prepared for two to eight hours. Changes in the comfort of masks (facial skin temperature, breathing resistance, and moisture permeability) and protection (filtration efficiency, resistance to blood penetration, and colony count) were assessed. The results demonstrated that the masks offered efficient liquid-particle filtering even after eight hours of use. However, the number of bacterial colonies using PM and SM grew significantly after two and four hours, respectively. Concerning comfort, the inspiratory resistance of masks rose dramatically after two hours, whereas the moisture permeability declined considerably after four hours. In addition, skin temperature had a significant increase within two hours, which may result in facial discomfort. When conditions permitted, the hospital staff was instructed to replace their masks every two hours.

3.
J Endovasc Ther ; : 15266028221119309, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36052406

RESUMO

CLINICAL IMPACT: Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. To meet the need for clinical monitoring and rapid decision making, the typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment have been summarized, which provide a reference for clinical preoperative risk assessment of AAA.

4.
Int J Numer Method Biomed Eng ; 38(7): e3605, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35481668

RESUMO

It is shown that certain locations in the arterial tree, such as coronary and cerebral arteries, are more prevalent to plaque formation. Endothelial activation and consequent plaque development are attributed to local hemodynamic parameters such as wall shear stress (WSS), oscillatory shear index (OSI), relative residence time (RRT), and stress phase angle. After a certain level of plaque progression, these hemodynamic parameters are disturbed before and after the plaque. In the current study, it is hypothesized that the vicinity of a primary lesion is susceptible for further degeneration and second plaque formation. A fluid-solid interaction (FSI) model of the coronary artery with different levels of asymmetric constriction, is simulated and the trend of hemodynamic parameters were studied in both of the plaque side (PS) and the opposite wall (facing the plaque [PF]). Also, a novel factor is introduced that can identify the high-risk regions associated with WSS oscillations to negative values. Our results indicate that when more than half of the artery is constricted, the downstream of the plaque is highly exposed to endothelial pathogenesis the PS, such that negative WSS, and as well, critical values of OSI and RRT, that is, -1.2 Pa, 0.42 and 6.5 s, respectively arise in this region. PS endothelial cells in this region exposed to the highest risk of atherosclerosis based on the proposed index (3 out of 3). As well, three cases of angiographic images are provided that confirms existence of secondary lesion close to the primary one as predicted by our computational simulations.


Assuntos
Placa Aterosclerótica , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Células Endoteliais , Hemodinâmica , Humanos , Modelos Cardiovasculares , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/patologia , Estresse Mecânico
5.
Comput Methods Programs Biomed ; 220: 106813, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35461127

RESUMO

BACKGROUND AND OBJECTIVE: Extracting the mechanical behaviors of bioprosthetic aortic valve leaflets is necessary for the appropriate design and manufacture of the prosthetic valves. The goal of this study was to opt a proper tissue for the valve leaflets by comparing the mechanical properties of the equine, porcine, and donkey pericardia with those of the bovine pericardium and human aortic valve leaflets. METHODS: After tissue fixation in glutaraldehyde, the mechanical behaviors of the pericardial tissues were experimentally evaluated through computational methods. The relaxation tests were performed along the tissue fiber direction. The Mooney-Rivlin model was utilized to describe the hyperelastic behavior of the tissues at the ramp portion. The viscous behaviors at the hold portion were extracted using the Fung quasi-linear viscoelastic (QLV) model. Furthermore, the extracted parameters were used in the modeling of the bovine, equine, porcine, and donkey pericardia through finite element analysis (FEA). RESULTS: Based on the results, relaxation percentages of the equine, donkey, and bovine pericardia were greater than that of the porcine pericardium and similar to the native human aortic valve leaflets. Indeed, the equine and donkey pericardia were found more viscous and less elastic than the porcine pericardium. Compared with the porcine pericardium, the mechanical properties of the equine and donkey pericardia were rather closer to those of the native human leaflets and bovine pericardium. The computational analysis demonstrated that the donkey pericardium is preferable over other types of pericardium due to the low stress on the leaflets during the systolic and diastolic phases and the large geometric orifice area (GOA). CONCLUSION: The donkey pericardium might be a good candidate valve leaflet material for bioprosthetic aortic valves.


Assuntos
Bioprótese , Próteses Valvulares Cardíacas , Animais , Valva Aórtica/cirurgia , Fenômenos Biomecânicos , Bovinos , Elasticidade , Análise de Elementos Finitos , Cavalos , Pericárdio , Suínos
7.
J Appl Biomater Funct Mater ; 19: 22808000211014007, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34223772

RESUMO

Water permeability of textile vascular grafts has been considered as a key indicator for predicting blood permeability after implantation. However, a correlation between water and blood permeability has not been established yet. Therefore, even though the water permeability of a vascular graft can be tested according to the standard ISO 7198, the results fail to guide a manufacturer or a surgeon to judge whether this vascular graft needs pre-clotting or not prior to implantation. As a result, all commercial graft products show almost zero water permeability, which leads to the loss of advantages that textile vascular grafts have the pore size-controlled porous wall. To solve this problem, four types of woven vascular grafts were designed and manufactured in the present work. Then their permeability to water, simulated plasma, and anticoagulated whole blood were measured at graded pressures from 8 to 16 kPa. Moreover, the correlations among the water permeability, the simulated plasma permeability, and the anticoagulated whole blood permeability were established. The results suggest that relatively steady correlations exist between the water permeability and the anticoagulated whole blood permeability, and that the evaluation of the blood permeability using the water permeability is feasible and objective. The present work provides a quantitative method for evaluating the blood permeability using the water permeability, and the latter is thus endowed with practical significance for guiding designs and clinical pre-clotting operations of textiles vascular grafts.


Assuntos
Prótese Vascular , Água , Permeabilidade , Têxteis
8.
Colloids Surf B Biointerfaces ; 203: 111728, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33819819

RESUMO

Electrospun nanofibrous membranes (NFMs) have attracted considerable attention as a potential physical barrier for reducing postoperative adhesion. However, no anti-adhesion barrier can completely prevent adhesion formation. In this study, phospholipid-functionalized NFMs were readily fabricated by one-step electrospinning to obtain nanofiber-based barriers with enhanced wettability and anti-adhesion efficiency. The optimized phospholipid NFMs were shown to have a fiber diameter of 831 nm ± 135 nm that is drastically decreasing, high porosity of 87.6 % ± 1.1 %, and superior hydrophilicity. Moreover, the phospholipid NFMs with excellent cytocompatibility exhibited fibroblasts being significantly reduced (≈ 51 %) after incubation of 3 days compared to that of the NFMs (≈ 96 %), confirming long-lasting anti-adhesion capability against fibroblasts. Meanwhile, less cell adhesion and proliferation of Raw 264.7 macrophages on NFM-10Lec indicated its superior anti-inflammatory effects. Thus, the facile phospholipid-functionalized nanofibers provided a promising strategy for anti-adhesion applications.


Assuntos
Nanofibras , Adesão Celular , Humanos , Membranas Artificiais , Fosfolipídeos , Aderências Teciduais
9.
J Endovasc Ther ; 28(2): 300-308, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33399011

RESUMO

PURPOSE: To evaluate the response of various stent-grafts after laser fenestration and dilation with noncompliant balloons to determine the optimal therapeutic combination for this treatment technique. MATERIALS AND METHODS: Five aortic stent-grafts were evaluated ex vivo: the Bolton RelayPlus, Jotec E-vita Thoracic 3G, Medtronic Valiant, Cook Zenith Alpha, and Vascutek Anaconda. Small holes were created using an excimer laser with the grafts submerged in saline. Five rows of 5 fenestrations were created, 4 holes in each row were dilated once with a 6-, 8-, 10-, or 12-mm-diameter noncompliant balloon to the specified nominal pressure (one hole served as the control). The saline solution from each stent-graft was collected and qualitatively analyzed for debris. The fenestrations were evaluated under light and scanning electron microscopes. The maximum diameter and area for each fenestration were measured. The direction and length of tears were assessed. RESULTS: The fenestration was feasible and reproducible in all the stent-grafts. The mean area of fenestration ranged from 7.63±1.63 to 14.75±0.73 mm2 when using balloons of 6- and 8-mm diameter, respectively. The 10- and 12-mm-diameter balloons caused a significant increase in area, variability, and tearing. The Anaconda graft tended to tear in the weft direction, while the other devices tore in the warp direction when using the 10- and 12-mm-diameter balloons. Dilation of the RelayPlus and Anaconda grafts with 6- and 8-mm-diameter balloons provided minimal tearing and precise fenestrations. Melted fiber remnants were observed after filtration of the saline solution for all devices. CONCLUSION: Laser fenestration and dilation with noncompliant balloons is a relatively simple and reproducible option for revascularization in urgent, complex aortic endovascular repairs. In our model, large balloons (ie, >10 mm) increased the destruction and tearing of the fabric. The maximum dilation recommended is 6 to 8 mm to avoid significant tears. Development of stent-grafts or novel fabrics designed explicitly for fenestration is needed to reduce potential complications.


Assuntos
Implante de Prótese Vascular , Procedimentos Endovasculares , Prótese Vascular , Dilatação , Humanos , Lasers , Desenho de Prótese , Stents , Resultado do Tratamento
11.
Mater Sci Eng C Mater Biol Appl ; 118: 111451, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33255038

RESUMO

The combination of nanofibre-based barriers and anti-adhesion drugs is potentially useful for adhesion prevention after ventral surgeries. However, drug molecules exposed to the surface of barriers easily result in an initial burst that is sharp, thus limiting the anti-adhesion efficiency. In this study, we developed a sandwiched electrospun scaffold loaded with ibuprofen (Sandwich) serving as a physical barrier, as well as an effectual carrier delivering it into the injured site for enhancing anti-adhesion capability. This Sandwich scaffold exhibited significantly a reduced initial burst of drug release in the first hour and a prolonged delivery for ibuprofen over 14 days, expected to provide the long-term anti-adhesion capability. In vitro study on fibroblasts showed that incorporation of ibuprofen effectively inhibited their adhesion and proliferation, and developed Sandwich maintained the least adhesion of L-929 after 5 days of culture (<20%). For RAW 264.7 macrophages, worse cell adhesion and poorer TNF-α production of Sandwich indicated its superior anti-inflammatory effect. In summary, the sandwiched ibuprofen-loaded scaffold showed promising potential for preventing adhesion formation.


Assuntos
Ibuprofeno , Nanofibras , Adesão Celular , Liberação Controlada de Fármacos , Humanos , Ibuprofeno/farmacologia , Aderências Teciduais
12.
Artif Organs ; 45(3): 278-288, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32969519

RESUMO

The damage caused to the fabric of endovascular stent-grafts most often occurs at the contact zones between the fabrics where they are attached to the apices of Z-shaped stents as a result of normal physiologic pulsatile movement within angulated vessels in vivo. Although design improvements were made over the years, the risks were not fully eliminated even with the newer M-shaped stent reconfiguration. In this study, we proposed to create and manufacture a novel fabric for stent-grafts with specifically designed reinforced zones to enhance resistance to fabric abrasion. These reinforced zones are set at the vicinity of the apices of the Z-shaped stents and between two adjacent Z-shaped stents where folding and pleating are commonly observed to occur in angulated vessels. Three innovative weaving structures with two different types of yarns and two controls were designed and prepared. Two commonly used commercial devices supported, respectively, with ringed stents, and Z-shaped stents were selected as the references for comparison. Textile structures including thickness, water permeability, mechanical properties, (more specifically tensile and bursting stress, as well as fatigue simulation) were tested on all fabrics. Compared to commercially available plain weaves, the fabrics with locally reinforced zones showed improved mechanical characteristics and fatigue resistant properties. A fabric designed with specifically reinforced zones has now clearly been shown to effectively reduce the abrasion caused by the apices of Z-shaped stents. However, further optimization may still be possible.


Assuntos
Implante de Prótese Vascular/efeitos adversos , Endoleak/prevenção & controle , Procedimentos Endovasculares/efeitos adversos , Desenho de Prótese , Têxteis , Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Endoleak/etiologia , Procedimentos Endovasculares/instrumentação , Teste de Materiais , Stents/efeitos adversos
13.
Morphologie ; 104(346): 202-213, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32518049

RESUMO

CLINICAL DATA: We hereby report a case of limb salvage involving a 64-year-old man who was hospitalized with ischemic foot ulcers for two months. Endarterectomy with patching and stenting of the left iliofemoral artery failed. A composite bypass of two segments of the endarterectomized superficial femoral artery and a cryopreserved saphenous vein graft was implanted one week later. On day 4 postoperatively, an infection (Staphylococcus epidermidis and Pseudomonas aeruginosa) was treated empirically with antibiotics. Four months later, the femoro-tibial bypass thrombosed and the patency was restored by thrombolysis. The aneurysmal cryopreserved vein was excised. Iterative complications followed and final success was attained after implantation of autologous cephalic and basilic veins. Four years later, this femoro-tibial is still patent. PATHOLOGICAL ANALYSES: After a gross observation, the explant was dissected and the most significant sections were processed for histology, followed by analyses in scanning electron microscopy, light microscopy and transmission electron microscopy. RESULTS: The explanted specimen showed a smooth flow surface proximally but a severe distortion distally, with an accumulation of poorly organized mural thrombi. The wall of the arterialized vein was accompanied with an important inflammatory reaction. The degradation of the collagen structure was evidenced in TEM. The fibrils of collagen were still individualized but were fragmented and did not display parallelly. The regular banding was preserved. The presence of Pseudomonas aeruginosa was shown inside the wall of the homologous vein. COMMENTS: In case of sepsis, the most aggressive antibiotic treatments cannot fully eliminate the bacteremic colonizations within the wall of an alternative conduit. The cephalic and basilic autologous veins are proved to be preferable in absence of the autologous saphenous vein. The amputation was prevented and four years later the bypass is still patent. This is an outstanding result based upon the comorbidities of the patient. The most aggressive harvesting shall be recommended. This patient represented a considerable challenge and the clinical result is highly gratifying: the search for the autologous cephalic and basilic veins proved to be worth the effort.


Assuntos
Braço , Salvamento de Membro , Veia Safena , Grau de Desobstrução Vascular , Aloenxertos , Criopreservação , Humanos , Isquemia/cirurgia , Perna (Membro)/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Artif Organs ; 44(3): 278-287, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31386771

RESUMO

Bioprosthetic heart valves still have poor long-term durability due to calcification and mechanical failure. The function and performance of bioprostheses is known to depend on the collagen architecture and mechanical behavior of the target tissue. So it is necessary to select an appropriate tissue for such prostheses. In this study, porcine, equine, and bovine pericardia were compared histologically and mechanically. The specimens were analyzed under light microscopy. The planar biaxial tests were performed on the tissue samples by applying synchronic loads along the axial (fiber direction) and perpendicular directions. The measured biaxial data were then fitted into both the modified Mooney-Rivlin model and the anisotropic four parameter Fung-type model. The modified Mooney-Rivlin model was applied to the modeling of the bovine, equine, and porcine pericardia using finite element analysis. The equine pericardium illustrated a wavy collagen bundle architecture similar to bovine pericardium, whereas the collagen bundles in the porcine pericardium were thinner and structured. Wavy pericardia may be preferable candidates for transcutaneous aortic valves because they are less likely to be delaminated during crimping. Based on the biaxial tensile test, the specimens indicated some degree of anisotropy; the anisotropy rates of the equine specimens were almost identical, and higher than the other two specimens. In general, porcine pericardium appeared stiffer, based on the greater strain energy magnitude and the average slope of the stress-stretch curves. Moreover, it was less distensible (due to lower areal strain) than the other two pericardial tissues. Furthermore, the porcine model induced localized high stress regions during the systolic and diastolic phases of the cardiac cycle. However, increased mechanical stress on the bioprosthetic leaflets may cause tissue degeneration and reduce the long-term durability of the valve. Based on our observations, the pericardial specimens behaved as anisotropic and nonlinear tissues-well-characterized by both the modified Mooney-Rivlin and the Fung-type models. The results indicate that, compared to bovine pericardium, equine tissue is mechanically and histologically more appropriate for manufacturing heart valve prostheses. The results of this study can be used in the design and manufacture of bioprosthetic heart valves.


Assuntos
Bioprótese , Próteses Valvulares Cardíacas , Pericárdio/ultraestrutura , Resistência à Tração , Animais , Fenômenos Biomecânicos , Bovinos , Colágeno/análise , Simulação por Computador , Elasticidade , Análise de Elementos Finitos , Cavalos , Teste de Materiais , Modelos Biológicos , Pericárdio/química , Suínos
15.
Biomed Mater ; 14(6): 065012, 2019 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-31530752

RESUMO

Surface modification by long-term active component is essential for biocompatible polymers-based vascular grafts to prevent thrombus formation and reduce intimal hyperplasia. In this study, a simple approach was developed to immobilize bioactive heparin to the surface of ε-polycaprolactone (PCL) grafts through a two-step strategy combining covalent grafting and layer by layer assembly of polyelectrolytes. The performance of heparinized PCL was evaluated in vitro, including the release behavior of heparin, anticoagulation and different types of cells adhesion characteristic. A sustained-release of heparin was achieved by this immobilization strategy. Surface remaining heparin was up to 1.10 µg cm-2 on the modified PCL after release in vitro for 30 d. Specifically, the heparinized PCL has the long-term ability to prevent adhesion of blood cells and thrombus formation, and significantly inhibit the adhesion of smooth muscle cells. The two-step strategy provides a simple and general route to incorporate heparin on PCL graft surface. The surface heparinized PCL demonstrated in this work can be a useful material platform for biodegradable vascular stent graft.


Assuntos
Anticoagulantes/química , Materiais Biocompatíveis/química , Prótese Vascular , Vasos Sanguíneos/transplante , Adesão Celular/efeitos dos fármacos , Animais , Coagulação Sanguínea , Eletrólitos , Heparina/química , Teste de Materiais , Microscopia de Força Atômica , Miócitos de Músculo Liso/citologia , Adesividade Plaquetária , Poliésteres/química , Ratos , Espectroscopia de Infravermelho com Transformada de Fourier , Stents , Propriedades de Superfície , Suínos , Resistência à Tração , Termogravimetria , Trombose/metabolismo , Trombose/prevenção & controle , Enxerto Vascular
16.
Artif Organs ; 43(10): 976-987, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31140630

RESUMO

Transcatheter aortic valve implantation (TAVI) has gained considerable acceptance in the past decade due to its lower risks than conventional open-heart surgery. However, the deformation and delamination of the leaflets during the crimping procedure have raised questions about the durability and long-term serviceability of the pericardium tissue from which the leaflets are made. The collagen architecture, wall thickness and mechanical properties of donkey pericardium were investigated to assess its suitability as an alternative material for the manufacture of heart valves. Coupons sampled from different locations of donkey pericardium were investigated. Bovine, equine, and porcine pericardium specimens served as controls. The donkey pericardium had a similar surface morphology to that of the control pericardia except for the wavy topology on both the fibrous and serous sides. The average thickness of donkey pericardium (ca. 120 µm) was significantly lower than that from bovine (375 µm) and equine (410 µm), but slightly higher than that from porcine (99 µm) specimens. The interlaced wavy collagen bundles in the pericardium were composed of collagen fibers about 100 nm in diameter. This unique structure ensures that the donkey pericardium has a comparable ultimate tensile strength (UTS) and a much higher failure strain than the commercial pericardia used for the manufacture of heart valves. The donkey pericardium has an organized wavy collagen bundle architecture similar to that of bovine pericardium and has a satisfactory UTS and high failure strain. The thin and strong donkey pericardium might be a good candidate valve leaflet material for TAVI.


Assuntos
Materiais Biocompatíveis/química , Bioprótese , Colágeno/análise , Próteses Valvulares Cardíacas , Pericárdio/química , Animais , Valva Aórtica/cirurgia , Fenômenos Biomecânicos , Bovinos , Elasticidade , Equidae , Valvas Cardíacas/cirurgia , Cavalos , Teste de Materiais , Pericárdio/ultraestrutura , Suínos , Resistência à Tração , Substituição da Valva Aórtica Transcateter
17.
J Biomed Mater Res B Appl Biomater ; 107(4): 965-977, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30265778

RESUMO

We screened a family of nonspecific cell-repelling polyurethanes (PUs) whose backbones are attached with epoxy group-terminated polyethylene glycol (PEG) side chains. Water incubation of the PU films (with 9.2-31.1 wt % PEG) caused a surface enrichment of PEG chains where vascular endothelial growth factor (VEGF) was grafted by forming secondary amine linkages between VEGF molecules and the PEG spacer. These linkages are still ionizable similar to original primary amines in VEGF, thereby retaining the original charge distribution on VEGF macromolecules. This charge conservation together with PEG steric repulsion helped to preserve VEGF conformation and bioactivity. The PU substrates with suitable hard segments contents and VEGF surface densities can selectively induce endothelial cells (ECs) adhesion and proliferation toward endothelialization. Moreover, the PU substrates, even grafted with fibrinogen (Fg), cannot trigger platelet adhesion and deformation, suggesting an inactive conformation of the grafted Fg. Thus enough antithrombogenicity of the PU substrates could be expected before full endothelialization. These PU materials might be applied onto the lumens of vascular grafts, potentially stimulating luminal endothelialization in vivo. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 965-977, 2019.


Assuntos
Materiais Revestidos Biocompatíveis , Células Endoteliais da Veia Umbilical Humana/metabolismo , Proteínas Imobilizadas , Teste de Materiais , Poliuretanos , Fator A de Crescimento do Endotélio Vascular , Adesão Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/farmacologia , Células Endoteliais da Veia Umbilical Humana/citologia , Humanos , Proteínas Imobilizadas/química , Proteínas Imobilizadas/farmacologia , Poliuretanos/química , Poliuretanos/farmacologia , Fator A de Crescimento do Endotélio Vascular/química , Fator A de Crescimento do Endotélio Vascular/farmacologia
18.
J Endovasc Ther ; 25(3): 397-407, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29692216

RESUMO

PURPOSE: To examine the effects of in situ laser fenestration and subsequent balloon dilation (noncompliant vs cutting) on the graft fabric of 4 aortic stent-graft models. METHOD: In an in vitro setup, the Zenith TX2, Talent, Endurant, and Anaconda aortic stent-grafts (all made of polyester graft material) were subjected to laser fenestration with a 2.3-mm-diameter probe at low and high energy in a physiologic saline solution followed by balloon dilation of the hole. For the first series of tests, 6-mm-diameter noncompliant balloons were used and replaced for the second series by 6-mm-diameter cutting balloons. Each procedure was performed 5 times (5 fenestrations per balloon type). The fenestrations were examined visually and with light and scanning electron microscopy. RESULTS: Each fenestration demonstrated various degrees of fraying and/or tearing regardless of the device. The monofilament twill weave of the Talent endograft tore in the warp direction up to 7.09±0.46 mm at high energy compared with 2.41±0.26 mm for the Endurant multifilament device. The fenestrations of the 3 endografts with multifilament weave (Zenith, Anaconda, and Endurant) showed more fraying; fenestration areas in the multifilament Endurant were >10 mm2 at low and high energy. The fenestrations were free of melted fibers, but minor blackening of the filaments was observed in all devices. Overall, the cutting balloons resulted in worse tearing and damage. Of note, the edges of the dilated laser-formed fenestrations of the Talent and the Endurant grafts demonstrated evidence of additional shredded yarns. CONCLUSION: In situ fenestration does not cause any melting of the polyester; however, the observed structural damage to the fabric construction must be carefully considered. Cutting balloons caused various levels of tearing compared to the noncompliant balloons and cannot be recommended for use in this application. Rather, noncompliant balloons should be employed, but only with endografts constructed from multifilament yarns. The use of in situ fenestration must be restricted to urgent and emergent cases until long-term durability can be determined.


Assuntos
Angioplastia com Balão , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Procedimentos Endovasculares/instrumentação , Lasers de Excimer , Microscopia Eletrônica de Varredura , Poliésteres/química , Stents , Aorta , Teste de Materiais , Desenho de Prótese
19.
Artif Organs ; 42(6): 630-639, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29602267

RESUMO

The benefit of bioprosthetic aortic valve over mechanical valve replacements is the release of thromboembolism and digression of long-term anticoagulation treatment. The function of bioprostheses and their efficiency is known to depend on the mechanical properties of the leaflet tissue. So it is necessary to select a suitable tissue for the bioprosthesis. The purpose of the present study is to clarify the viscoelastic behavior of bovine, equine, and porcine pericardium. In this study, pericardiums were compared mechanically from the viscoelastic aspect. After fixation of the tissues in glutaraldehyde, first uniaxial tests with different extension rates in the fiber direction were performed. Then, the stress relaxation tests in the fiber direction were done on these pericardial tissues by exerting 20, 30,40, and 50% strains. After evaluation of viscoelastic linearity, the Prony series, quasilinear viscoelastic (QLV) and modified superposition theory were applied to the stress relaxation data. Finally, the parameters of these constitutive models were extracted for each pericardium tissue. All three tissues exhibited a decrease in relaxation rate with elevating strain, indicating the nonlinear viscoelastic behavior of these tissues. The three-term Prony model was selected for describing the linear viscoelasticity. Among different models, the QLV model was best able to capture the relaxation behavior of the pericardium tissues. More stiffness of porcine pericardium was observed in comparison to the two other pericardium tissues. The relaxation percentage of porcine pericardium was less than the two others. It can be concluded that porcine pericardium behaves more as an elastic and less like a viscous tissue in comparison to the bovine and equine pericardium.


Assuntos
Bioprótese , Próteses Valvulares Cardíacas , Pericárdio/química , Algoritmos , Animais , Materiais Biocompatíveis/química , Fenômenos Biomecânicos , Bovinos , Elasticidade , Desenho de Equipamento , Cavalos , Teste de Materiais/instrumentação , Modelos Biológicos , Estresse Mecânico , Suínos , Viscosidade
20.
J Mech Behav Biomed Mater ; 75: 455-462, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28823899

RESUMO

The success of blood conduit replacement with synthetic graft is highly dependent on the architecture, and mechanical properties of the graft, especially for biodegradable grafts serving as scaffolds for in-situ tissue engineering. Particularly, the property of the radial compression recovery represents a critical to keep the patency during biointegration. Bi-component composite vascular grafts (cVG) made of polylactic acid (PLA) fabric and polycaprolactone (PCL) were developed with superior mechanical properties. In this research, the compressive and tensile properties of the prototypes were characterized when they were subjected to accelerated degradation. In addition, the prepared cVG were analyzed by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and wide angle X-ray diffraction (WAXD) to illustrate the gradual loss of mechanical properties. The results demonstrated that the cVG retained the circular cross-section even through its tensile strength decreased during degradation. The cVG samples containing a high percentage of PLA fibers lost their tensile strength faster, while the samples with lower PLA percentage lost the compressive resistance strength more quickly. This unique fabric-based composite biodegradable vascular prosthesis with an outstanding radical compression recovery could be a good candidate for in-situ formation of tissue engineered vascular graft.


Assuntos
Implantes Absorvíveis , Prótese Vascular , Poliésteres/análise , Alicerces Teciduais , Força Compressiva , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Resistência à Tração , Engenharia Tecidual , Difração de Raios X
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