title: Evaluation of a novel thermosensitive heparin-poloxamer hydrogel for improving vascular anastomosis quality and safety in a rabbit model.
abstract: Despite progress in the design of advanced surgical techniques, stenosis recurs in a large percentage of vascular anastomosis. In this study, a novel heparin-poloxamer (HP) hydrogel was designed and its effects for improving the quality and safety of vascular anastomosis were studied. HP copolymer was synthesized and its structure was confirmed by Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance spectroscopy ((1)H-NMR). Hydrogels containing HP were prepared and their important characteristics related to the application in vascular anastomosis including gelation temperature, rheological behaviour and micromorphology were measured. Vascular anastomosis were performed on the right common carotid arteries of rabbits, and the in vivo efficiency and safety of HP hydrogel to achieve vascular anastomosis was verified and compared with Poloxamer 407 hydrogel and the conventional hand-sewn method using Doppler ultrasound, CT angiograms, scanning electron microscopy (SEM) and histological technique. Our results showed that HP copolymer displayed special gel-sol-gel phase transition behavior with increasing temperature from 5 to 60 °C. HP hydrogel prepared from 18 wt% HP solution had a porous sponge-like structure, with gelation temperature at approximately 38 °C and maximum elastic modulus at 10,000 Pa. In animal studies, imaging and histological examination of rabbit common jugular artery confirmed that HP hydrogel group had similar equivalent patency, flow and burst strength as Poloxamer 407 group. Moreover, HP hydrogel was superior to poloxamer 407 hydrogel and hand-sewn method for restoring the functions and epithelial structure of the broken vessel junctions after operation. By combining the advantages of heparin and poloxamer 407, HP hydrogel holds high promise for improving vascular anastomosis quality and safety.
authors.affiliation: Wenzhou Medical University, Wenzhou City, Zhejiang Province, China ; College of Medicine, Drexel University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Ying-Zheng
authors.initials: YZ
authors.lastname: Zhao
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Lv
authors.forename: Cui-Tao
authors.initials: CT
authors.lastname: Lu
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Chen
authors.forename: Min
authors.initials: M
authors.lastname: Lin
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Jiang
authors.forename: Xiao-Tong
authors.initials: XT
authors.lastname: Shen
authors.forename: Rong-Rong
authors.initials: RR
authors.lastname: Jin
authors.forename: Jun
authors.initials: J
authors.lastname: Cai
authors.forename: Xin-Qiao
authors.initials: XQ
authors.lastname: Tian
authors.forename: Ho Lun
authors.initials: HL
authors.lastname: Wong
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure; D002533:Cerebral Angiography; D006493:Heparin / Q000737:chemistry*; D006801:Humans; D020100:Hydrogels / Q000737:chemistry*; D020442:Poloxamer / Q000737:chemistry*; D011786:Quality Control; D011817:Rabbits; D012449:Safety
chemical_list: D020100:Hydrogels; D020442:Poloxamer; D006493:Heparin