Animal models for the assessment of novel vascular conduits.

Objective: Despite their clinical introduction 10 years ago, no human series on the healing response to Amplatzer and Starflex devices in humans have been reported yet. We sought to investigate the biocompatibility of Amplatzer and Cardioseal/Starflex septal occluder devices in humans and compare the findings to results in experimental animals. Methods: The healing response of Amplatzer and Cardioseal/Starflex septal occluder devices in humans (n = 12, follow-up periods from 5 days to 4 years) and in experimental animals (n = 32, follow-up periods from 4 days to 1 year) was studied using a uniform work up protocol. Histological sections of paraffin-wax-embedded or methacrylate-embedded specimen and scanning electron microscopy were used for biocompatibility screening. Results: Neoendothelialisation of all examined devices was complete after 3 months in vivo. Protruding metal frame parts, like screw threads and spring arms, were covered last. The initial deposition of fibrin and blood cells on the polyester fabric was subsequently organised by ingrown fibroblastic cells. Loosely arranged and poorly vascularised young granulation tissue was transformed time-dependently into quiescent fibre-rich connective repair tissue poor of cellular and capillary vessel components. Consistently, a mild chronic inflammatory response directed against textile fibres of both types of implants characterised by lymphocytic infiltration and multinucleated foreign body giant cells was observed equally in human and animal explants. Conclusions: Systematic biocompatibility screening in a series of explanted human septal occluder devices showed results corresponding to findings in animal studies with regard to neoendothelialisation, cellular organisation of initial thrombus and persisting immune response.

https://heart.bmj.com/content/heartjnl/93/4/444.full.pdf

Biocompatibility of septal defect closure devices

A comprehensive study of ovine haemostasis to assess suitability to model human coagulation

To date, a wide range of materials, from synthetic to natural or a mixture of these, has been explored, modified, and examined as small-diameter tissue-engineered vascular grafts (SD-TEVGs) for tissue regeneration either in vitro or in vivo. However, very limited success has been achieved due to mechanical failure, thrombogenicity or intimal hyperplasia, and improvements of the SD-TEVG design are thus required. Here, in vivo studies investigating novel and relative long (10 times of the inner diameter) SD-TEVGs in large animal models and humans are identified and discussed, with emphasis on graft outcome based on model- and graft-related conditions. Only a few types of synthetic polymer-based SD-TEVGs have been evaluated in large-animal models and reflect limited success. However, some polymers, such as polycaprolactone (PCL), show favorable biocompatibility and potential to be further modified and improved in the form of hybrid grafts. Natural polymer- and cell-secreted extracellular matrix (ECM)-based SD-TEVGs tested in large animals still fail due to a weak strength or thrombogenicity. Similarly, native ECM-based SD-TEVGs and in-vitro-developed hybrid SD-TEVGs that contain xenogeneic molecules or matrix seem related to a harmful graft outcome. In contrast, allogeneic native ECM-based SD-TEVGs, in-vitro-developed hybrid SD-TEVGs with allogeneic banked human cells or isolated autologous stem cells, and in-body tissue architecture (IBTA)-based SD-TEVGs seem to be promising for the future, since they are suitable in dimension, mechanical strength, biocompatibility, and availability.

https://www.mdpi.com/2073-4409/10/3/713/pdf

Review: Tissue Engineering of Small-Diameter Vascular Grafts and Their In Vivo Evaluation in Large Animals and Humans.

Background: Whole blood platelet aggregometry (impedance) is an important method to investigate platelet function disorders. Examination of hemostatic function in sheep is important with respect to their role as an animal model of human disease.



Objective: The aim of this study was to evaluate and optimize selected methodological aspects (anticoagulant, agonist concentration) of impedance aggregometry in ovine blood using the new Multiplate 5.0 analyzer.



Methods: Blood samples were collected in hirudin anticoagulant from 40 clinically healthy sheep. Samples from selected sheep were collected in citrate, with or without the addition of calcium chloride. The agonists adenosine diphosphate (ADP), collagen, ristocetin, arachidonic acid, and thrombin receptor-activating peptide (TRAP) were added in several concentrations to induce aggregation.



Results: Based on maximum aggregation values and internal precision, no significant difference was found between ADP concentrations of 3–10 μmol/L and collagen concentrations of 3–5 μg/mL (P>.05). The lowest interindividual variation of approximately 3–4-fold was seen with 4 and 5 μmol/L ADP and 4 and 5 μg/mL collagen. Ristocetin, arachidonic acid, and TRAP did not induce significant aggregation at any concentration. Aggregation results were significantly lower when measured in citrate- vs hirudin-anticoagulated blood, regardless of the presence of calcium chloride.



Conclusions: Our results indicate that the multiplate impedance aggregometer is suitable for the measurement of platelet aggregation in sheep using optimal agonist concentrations of 4–5 μmol/L ADP and 4–5 μg/mL collagen. Hirudin-anticoagulated blood is the preferred sample material.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-165X.2009.00198.x

Hristos G. Spanos

Papers

Aspirin fails to inhibit platelet aggregation in sheep.