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Submitted on June 20, 2006
Accepted on November 6, 2006
From Division of Cardiovascular, Thoracic, and Pediatric Surgery (T.H., K.O., Y.M., Y.O.), Kobe University Graduate School of Medicine, Kobe, Japan; Department of Biomaterials (Y.T.), Field of Tissue Engineering, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan; Division of Molecular Medicine and Medical Genetics (Y.H.), International Center for Medical Research and Treatment (ICMRT), Kobe University Graduate School of Medicine, Kobe, Japan.
* To whom correspondence should be addressed. E-mail: yokita{at}aol.com.
Objectives--Autologous vein grafts are still widely used, but their long-term patency is suboptimal. The objective of the current study was to determine whether wrapping a vein graft in gelatin hydrogel sheet incorporating basic fibroblast growth factor improves their mechanical and physiological properties.
Methods and Results--Autologous femoral vein was interposed into the abdominal aorta in rats. The rats were divided into 3 groups: nontreated grafts (group A), grafts wrapped in basic fibroblast growth factor-free gelatin hydrogel sheet (group B), and grafts wrapped in basic fibroblast growth factor-impregnated gelatin hydrogel sheet (group C). On day 1, endothelial desquamation was observed in group A, and the media in groups A and B were disrupted, staining positive in the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay. In contrast, the media in group C remained intact and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-negative, associated with activation of MAPK. Graft dilation was significantly inhibited in groups B and C compared with group A, with those in group C showing the smallest degree of neointimal proliferation. At 8 weeks grafts in group C developed neointima with homogeneous elastic laminae, presence of rigid neoadventitia that displayed neovascularity, and the highest blood flow velocity.
Conclusions--Wrapping vein grafts in basic fibroblast growth factor- impregnated gelatin hydrogel sheet improved their structural and physiological properties, and might therefore also improve long-term patency.
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