Abstract

ObjectiveIntravascular stents are commonly used to treat occluded arteries during coronary heart disease. After coronary stent implantation, endothelial cells grow over the stent, which is referred to as re-endothelialization. Re-endothelialization prevents blood from clotting on the stent surface and is a good predictor of stent success. Blood vessel mimics (BVMs) are in vitro tissue-engineered models of human blood vessels that may be used to preclinically test stents for re-endothelialization. BVMs have been developed in straight geometries. However, the United States Food and Drug Administration recommends that devices intended to treat coronary occlusions be preclinically tested in bent and bifurcated vessels due to the complex geometries of native coronary arteries. The main objectives of this study were to develop and characterize BVMs in complex geometries.DesignBioreactors were designed and constructed so that BVMs could be cultivated in bent (>45°) and bifurcated geometries. Human umbilical vein endothelial cells were sodded onto complex-shaped scaffolds, and the resulting BVMs were characterized for cell deposition. For a final proof of concept, a coronary stent was deployed in a severely angulated BVM.ResultsThe new bioreactors were easy to use and mounting scaffolds in complex geometries in the bioreactors was successful. After sodding scaffolds with cells, there were no statistically significant differences between the cell densities along the length of the BVMs, on the top and bottom halves of the BVMs, or on the inner and outer halves of the BVMs. This suggests cells deposited evenly throughout the scaffolds, resulting in consistent complex-geometry BVMs. Also, a coronary stent was successfully deployed in a severely angulated BVM.ConclusionsBioreactors can be constructed for housing complex-shaped vessels. BVMs can be developed in the complex geometries observed in native coronary arteries with endothelial cells evenly dispersed throughout BVM lumens.

Highlights

  • Coronary heart disease (CHD), which is the leading cause of death in the United States [1], occurs when plaque occludes coronary arteries

  • Blood vessel mimics (BVMs) can be developed in the complex geometries observed in native coronary arteries with endothelial cells evenly dispersed throughout BVM lumens

  • We previously showed that HUVECs are a cost-effective cell type for generating BVMs in straight geometries [8]

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Summary

Introduction

Coronary heart disease (CHD), which is the leading cause of death in the United States [1], occurs when plaque occludes coronary arteries. Coronary occlusions can be treated with stents [2]. Stents are latticed tubes that can be crimped onto catheters and deployed at blockage sites [3]. Stents denude endothelial cells from vessel walls, but eventually a new endothelial lining grows over the stented region [4,5]. This re-growth is known as reendothelialization and is important for successful healing after stent implantation. A confluent monolayer of endothelial cells modulates local hemostasis and thrombolysis and protects vascular smooth muscle cells from circulating growth-promoting factors [5]

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