Preliminary evaluation of a technique for inhibiting intimal hyperplasia: implantation of a resorbable luminal collagen membrane.
Pharmacologic control of intimal hyperplasia has been attempted through oral and intravenous administration of smooth muscle cell inhibitors. We report a more direct method of altering arterial healing using a novel bioresorbable membrane that can be applied to the lumen of an artery or anastomosis following endarterectomy or vascular reconstruction. Following a standard balloon injury, the infrarenal aortas of 3 kg female New Zealand white rabbits were opened and a thin membrane composed of collagen/chondroitin 6-sulfate copolymer was sutured to the posterior wall of each artery. Animals were killed at intervals of up to 3 months. All arteries remained patent. By 24 hours the membrane had become infiltrated with fibrin and red blood cells. An inflammatory response ensued and by 8 days the membrane was filled with mononuclear cells. At 3 months only a small remnant of the membrane remained. Intimal hyperplasia developed throughout the injured aorta. However, the hyperplastic response beneath the membrane was no greater than that observed in the adjacent injured aorta. A bioresorbable membrane can be sutured into the lumen of a small-diameter vessel without inducing thrombosis and without locally increasing intimal hyperplasia. A prosthesis of this type might be used to deliver inhibitors of smooth muscle cell proliferation and migration to the injured arterial wall.
Kent
K C
KC
Department of Surgery, Beth Israel Hospital, Boston, MA 02215, USA.
Mii
S
S
Brown
L F
LF
Nagle
T
T
Yannas
I V
IV
D000042:Absorption; D000818:Animals; D001705:Bioprosthesis; D002809:Chondroitin Sulfates / Q000494:pharmacology; D003094:Collagen / Q000494:pharmacology*; D005260:Female; D006965:Hyperplasia; D008567:Membranes, Artificial; D019736:Prostheses and Implants; D011817:Rabbits; D013927:Thrombosis / Q000517:prevention & control; D017539:Tunica Intima / Q000293:injuries / Q000473:pathology*; D014656:Vascular Surgical Procedures / Q000379:methods; D014945:Wound Healing / Q000187:drug effects
D008567:Membranes, Artificial; D002809:Chondroitin Sulfates; D003094:Collagen