Abstract
This study was aimed at generating data for designing a potential method to prevent the rupture of the abdominal aortic aneurysm (AAA). We found that the mechanical strength and stiffness of blood vessel walls was enhanced by the crosslinking of adventitial collagen through a photochemical process promoted by ultraviolet-A (UV-A) radiation. The experiments were carried out on samples isolated from 25 normal porcine aortas. The adventitial layer was separated from the other layers and exposed to UV radiation of 365-nm wavelength, in the presence of a riboflavin compound as the photosensitizer. Mechanical testing of 30 specimens, prior to and after exposure, indicated an increase in both strength (ultimate stress) and stiffness (Young’s modulus) of the adventitial specimens following irradiation. The crosslinking process also led to an enhanced resistance to experimental collagenolysis, as determined on six specimens. At this phase of conceptual design, we suggest that by applying this method to an aneurysmal dilated wall region, the stabilization of tunica adventitia may delay or prevent the rupture of the aneurysm and, with further investigation and refinement, can become a therapeutic strategy for arresting the progression of AAA.
Highlights
In spite of an impressive volume of experimental research, extensive published literature on its pathophysiology and therapeutic strategies, and a significant number of related clinical trials, the abdominal aortic aneurysm (AAA) remains a pathological condition associated with high morbidity and mortality rates
There are two types of the procedure, the traditional open surgical repair (OSR) and the newer endovascular aneurysm repair (EVAR) surgery, which both are associated with satisfactory perioperative mortality rates, some postoperative complications and the occasional need for re-interventions are still present [1,2,3,4,5]
We report here the development of a method aimed at mechanically reinforcing the aortic adventitial collagen through its chemical crosslinking induced by ultraviolet-A (UV-A) radiation in the presence of riboflavin 5 -phosphate monosodium salt
Summary
In spite of an impressive volume of experimental research, extensive published literature on its pathophysiology and therapeutic strategies, and a significant number of related clinical trials, the abdominal aortic aneurysm (AAA) remains a pathological condition associated with high morbidity and mortality rates. Repair surgery is the only treatment for AAAs, applicable preventively for aneurysms larger than 5 to 5.5 cm in diameter, and to ruptured aneurysms in emergency settings. There are two types of the procedure, the traditional open surgical repair (OSR) and the newer endovascular aneurysm repair (EVAR) surgery, which both are associated with satisfactory perioperative mortality rates, some postoperative complications and the occasional need for re-interventions are still present [1,2,3,4,5]. Intensive research has been dedicated lately to a more in-depth understanding of the pathogenesis of AAA, and to develop non-surgical treatment approaches, such as pharmacologic or cellular therapies [3,4,6,7,8], and is anticipated that novel strategies for treating AAA will emerge in the near future
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