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An injectable tissue-engineered embolus prevents luminal recanalization after vascular sclerotherapy.
MedLine Citation:
PMID:  15991171     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Sclerotherapy for vascular malformations is often limited by luminal recanalization. This study examined whether an injectable tissue-engineered construct could prevent this complication in a rabbit model of venous sclerotherapy. METHODS: Ethanol sclerotherapy of a temporarily occluded jugular vein segment was performed in 46 rabbits, which were then divided into 3 groups. Group I (n = 16) had no further manipulations. In groups II (n = 15) and III (n = 15), 0.5 mL collagen hydrogel was injected intraluminally, respectively, devoid of and seeded with autologous fibroblasts. At 1, 4, and 20 to 24 weeks postoperatively, vein segments were examined for patency and resected for histological evaluation. Statistical analysis was by Fisher's Exact test. RESULTS: All vein segments were occluded at 1 and 4 weeks in all groups, despite histological evidence of progressive endothelial ingrowth. However, at 20 to 24 weeks, angiography demonstrated restoration of vessel patency in groups I (3/6) and II (3/5), but not in group III (0/6; P = .043), in which histology confirmed an obliterated lumen for all vessels. CONCLUSION: An injectable, fibroblast-based, engineered construct prevents midterm to long-term recanalization in a leporine model of vascular sclerotherapy. This novel therapeutic approach may prevent recurrence of vascular malformations after sclerotherapy, thus reducing the need for repeated procedures and morbid operative resections.
Authors:
C Jason Smithers; Adam M Vogel; Harry P W Kozakewich; Deborah A Freedman; Patricia E Burrows; Dario O Fauza; Steven J Fishman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  40     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-07-01     Completed Date:  2006-05-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  920-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteriovenous Malformations / therapy*
Disease Models, Animal
Ethanol / therapeutic use
Fibroblasts / transplantation
Humans
Hydrogel / administration & dosage
Inflammation / prevention & control*
Injections, Intravenous
Jugular Veins / abnormalities*,  anatomy & histology
Rabbits
Sclerosing Solutions*
Sclerotherapy / methods*
Tissue Engineering
Transplantation, Autologous
Chemical
Reg. No./Substance:
0/Sclerosing Solutions; 25852-47-5/Hydrogel; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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