Enhancement of intravascular sclerotherapy by tissue engineering: short-term results.
OBJECTIVE
Treatment of vascular malformations with sclerotherapy is often complicated by reexpansion secondary to endothelial recanalization. This study examined the use of an autologous fibroblast construct to enhance intraluminal scar formation after sclerotherapy.


METHODS
New Zealand rabbits (n = 15) underwent ethanol sclerotherapy of a segment of the facial vein. After intraluminal saline flush, animals were equally divided into 3 groups. In group I, no further manipulations were performed. In groups II and III, collagen hydrogel was injected into the sclerosed vein, respectively, without and seeded with autologous green fluorescent protein-labeled fibroblasts. One week postoperatively, the vein segments were examined for patency and resected for histology.


RESULTS
The sclerosed vein segments remained occluded in all animals. Histological examination of luminal thrombi demonstrated numerous viable fibroblasts in group III, whereas there were none in the control specimens from groups I and II. The presence of the injected autologous green fluorescent protein-labeled fibroblasts within thrombi of group III was confirmed by immunohistochemistry.


CONCLUSIONS
An injectable tissue-engineered construct enhances sclerotherapy of the jugular vein in a leporine model by reliably delivering fibroblasts that populate the resultant thrombus. Further analysis of this novel therapeutic concept as a means to augment permanent scar formation and reduce luminal recanalization is warranted.
Smithers
C Jason
CJ
Department of Surgery, Children's Hospital Boston, Boston, MA 02115, USA.
Vogel
Adam M
AM
Kozakewich
Harry P
HP
Freedman
Deborah A
DA
Udagawa
Taturo
T
Burrows
Patricia E
PE
Fauza
Dario O
DO
Fishman
Steven J
SJ
D000818:Animals; D018376:Cardiovascular Abnormalities / Q000628:therapy; D002921:Cicatrix; D005145:Face / Q000098:blood supply; D005347:Fibroblasts / Q000637:transplantation*; D020100:Hydrogels; D011817:Rabbits; D015911:Sclerotherapy / Q000379:methods*; D023822:Tissue Engineering; D014680:Veins / Q000002:abnormalities*
D020100:Hydrogels