A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig

John Josef; Vito Domenico Bruno; Nadiah Sulaiman; Alexander Ward; Thomas W Johnson; Helna M  Baby; Shantikumar V Nair; Deepthy Menon; Sarah J George; Raimondo Ascione

doi:10.1186/s12951-022-01268-1

A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig

John Josef, Vito Domenico Bruno, Nadiah Sulaiman, Alexander Ward, Thomas W Johnson, Helna M Baby, Shantikumar V Nair, Deepthy Menon^*, Sarah J George^*, Raimondo Ascione^*

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

Globally, millions of patients are affected by myocardial infarction or lower limb gangrene/amputation due to atherosclerosis. Available surgical treatment based on vein and synthetic grafts provides sub-optimal benefits. We engineered a highly flexible and mechanically robust nanotextile-based vascular graft (NanoGraft) by interweaving nanofibrous threads of poly-L-lactic acid to address the unmet need. The NanoGrafts were rendered impervious with selective fibrin deposition in the micropores by pre-clotting. The pre-clotted NanoGrafts (4 mm diameter) and ePTFE were implanted in a porcine carotid artery replacement model. The fibrin-laden porous milieu facilitated rapid endothelization by the transmural angiogenesis in the NanoGraft. In-vivo patency of NanoGrafts was 100% at 2- and 4-weeks, with no changes over time in lumen size, flow velocities, and minimal foreign-body inflammatory reaction. However, the patency of ePTFE at 2-week was 66% and showed marked infiltration, neointimal thickening, and poor host tissue integration. The study demonstrates the in-vivo feasibility and safety of a thin-layered vascular prosthesis, viz., NanoGraft, and its potential superiority over the commercial ePTFE.

Original language	English
Article number	71
Pages (from-to)	1-13
Number of pages	13
Journal	Journal of Nanobiotechnology
Volume	20
Issue number	1
DOIs	https://doi.org/10.1186/s12951-022-01268-1
Publication status	Published - 8 Feb 2022

Bibliographical note

Funding Information:
Joseph acknowledges the Commonwealth Scholarship Commission for the Split-site scholarship (INCN-2016-176) held with Prof. George at the University of Bristol, United Kingdom, and CSIR for Senior Research Fellowship (9/963(0035)2k14-EMRI). We thank the staff at the University of Bristol Translational Biomedical Research Centre, a UK national research facility for large animal co-funded by the British Heart Foundation and the Medical Research Council. In addition, we acknowledge Amrita Vishwa Vidyapeetham for infrastructural support and Drs Praveen Kerala Varma and Rajesh Jose, Department of Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, for supporting previous in-vivo studies in rabbit in Amrita.

Funding Information:
The bench-testing in a dynamic bioreactor and all the in-vivo feasibility studies presented in this manuscript were supported by grants awarded to Prof. Ascione: the British Heart Foundation (BHF) (BHF IG/14/2/30991, and BHF/PG/16/104/32652), the University of Bristol Alumni, and the Medical Research Council (MRC) (MRC MR/L012723/1). The development of the NanoGraft technology at Amrita was funded by Department of Science and Technology (DST), Government of India, through the “Thematic Projects in Frontiers of Nanoscience & Technology” (SR/NM/TP-15/2016G). The laboratory assays part of this study was supported by the Commonwealth Scholarship Commission, United Kingdom (INCN-2016-176).

Publisher Copyright:
© 2022, The Author(s).

Keywords

Nanotextile
Small diameter vascular grafts
Endothelialisation
Nanofibers
Electrospinning
In-vivo feasibility
Coronary surgery
Vascular surgery
Nanotextile vascular prosthesis
Vascular graft failure
Tissue engineering

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Josef, J., Bruno, V. D., Sulaiman, N., Ward, A., Johnson, T. W., Baby, H. M., Nair, S. V., Menon, D., George, S. J., & Ascione, R. (2022). A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig. Journal of Nanobiotechnology, 20(1), 1-13. Article 71. https://doi.org/10.1186/s12951-022-01268-1

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abstract = "Globally, millions of patients are affected by myocardial infarction or lower limb gangrene/amputation due to atherosclerosis. Available surgical treatment based on vein and synthetic grafts provides sub-optimal benefits. We engineered a highly flexible and mechanically robust nanotextile-based vascular graft (NanoGraft) by interweaving nanofibrous threads of poly-L-lactic acid to address the unmet need. The NanoGrafts were rendered impervious with selective fibrin deposition in the micropores by pre-clotting. The pre-clotted NanoGrafts (4 mm diameter) and ePTFE were implanted in a porcine carotid artery replacement model. The fibrin-laden porous milieu facilitated rapid endothelization by the transmural angiogenesis in the NanoGraft. In-vivo patency of NanoGrafts was 100\% at 2- and 4-weeks, with no changes over time in lumen size, flow velocities, and minimal foreign-body inflammatory reaction. However, the patency of ePTFE at 2-week was 66\% and showed marked infiltration, neointimal thickening, and poor host tissue integration. The study demonstrates the in-vivo feasibility and safety of a thin-layered vascular prosthesis, viz., NanoGraft, and its potential superiority over the commercial ePTFE.",

keywords = "Nanotextile, Small diameter vascular grafts, Endothelialisation, Nanofibers, Electrospinning, In-vivo feasibility, Coronary surgery, Vascular surgery, Nanotextile vascular prosthesis, Vascular graft failure, Tissue engineering",

author = "John Josef and Bruno, \{Vito Domenico\} and Nadiah Sulaiman and Alexander Ward and Johnson, \{Thomas W\} and Baby, \{Helna M\} and Nair, \{Shantikumar V\} and Deepthy Menon and George, \{Sarah J\} and Raimondo Ascione",

note = "Funding Information: Joseph acknowledges the Commonwealth Scholarship Commission for the Split-site scholarship (INCN-2016-176) held with Prof. George at the University of Bristol, United Kingdom, and CSIR for Senior Research Fellowship (9/963(0035)2k14-EMRI). We thank the staff at the University of Bristol Translational Biomedical Research Centre, a UK national research facility for large animal co-funded by the British Heart Foundation and the Medical Research Council. In addition, we acknowledge Amrita Vishwa Vidyapeetham for infrastructural support and Drs Praveen Kerala Varma and Rajesh Jose, Department of Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences \& Research Centre, Amrita Vishwa Vidyapeetham, for supporting previous in-vivo studies in rabbit in Amrita. Funding Information: The bench-testing in a dynamic bioreactor and all the in-vivo feasibility studies presented in this manuscript were supported by grants awarded to Prof. Ascione: the British Heart Foundation (BHF) (BHF IG/14/2/30991, and BHF/PG/16/104/32652), the University of Bristol Alumni, and the Medical Research Council (MRC) (MRC MR/L012723/1). The development of the NanoGraft technology at Amrita was funded by Department of Science and Technology (DST), Government of India, through the “Thematic Projects in Frontiers of Nanoscience \& Technology” (SR/NM/TP-15/2016G). The laboratory assays part of this study was supported by the Commonwealth Scholarship Commission, United Kingdom (INCN-2016-176). Publisher Copyright: {\textcopyright} 2022, The Author(s).",

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Josef, J, Bruno, VD, Sulaiman, N, Ward, A, Johnson, TW, Baby, HM, Nair, SV, Menon, D, George, SJ & Ascione, R 2022, 'A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig', Journal of Nanobiotechnology, vol. 20, no. 1, 71, pp. 1-13. https://doi.org/10.1186/s12951-022-01268-1

A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig. / Josef, John; Bruno, Vito Domenico; Sulaiman, Nadiah et al.
In: Journal of Nanobiotechnology, Vol. 20, No. 1, 71, 08.02.2022, p. 1-13.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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T1 - A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig

AU - Josef, John

AU - Bruno, Vito Domenico

AU - Sulaiman, Nadiah

AU - Ward, Alexander

AU - Johnson, Thomas W

AU - Baby, Helna M

AU - Nair, Shantikumar V

AU - Menon, Deepthy

AU - George, Sarah J

AU - Ascione, Raimondo

N1 - Funding Information: Joseph acknowledges the Commonwealth Scholarship Commission for the Split-site scholarship (INCN-2016-176) held with Prof. George at the University of Bristol, United Kingdom, and CSIR for Senior Research Fellowship (9/963(0035)2k14-EMRI). We thank the staff at the University of Bristol Translational Biomedical Research Centre, a UK national research facility for large animal co-funded by the British Heart Foundation and the Medical Research Council. In addition, we acknowledge Amrita Vishwa Vidyapeetham for infrastructural support and Drs Praveen Kerala Varma and Rajesh Jose, Department of Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, for supporting previous in-vivo studies in rabbit in Amrita. Funding Information: The bench-testing in a dynamic bioreactor and all the in-vivo feasibility studies presented in this manuscript were supported by grants awarded to Prof. Ascione: the British Heart Foundation (BHF) (BHF IG/14/2/30991, and BHF/PG/16/104/32652), the University of Bristol Alumni, and the Medical Research Council (MRC) (MRC MR/L012723/1). The development of the NanoGraft technology at Amrita was funded by Department of Science and Technology (DST), Government of India, through the “Thematic Projects in Frontiers of Nanoscience & Technology” (SR/NM/TP-15/2016G). The laboratory assays part of this study was supported by the Commonwealth Scholarship Commission, United Kingdom (INCN-2016-176). Publisher Copyright: © 2022, The Author(s).

PY - 2022/2/8

Y1 - 2022/2/8

N2 - Globally, millions of patients are affected by myocardial infarction or lower limb gangrene/amputation due to atherosclerosis. Available surgical treatment based on vein and synthetic grafts provides sub-optimal benefits. We engineered a highly flexible and mechanically robust nanotextile-based vascular graft (NanoGraft) by interweaving nanofibrous threads of poly-L-lactic acid to address the unmet need. The NanoGrafts were rendered impervious with selective fibrin deposition in the micropores by pre-clotting. The pre-clotted NanoGrafts (4 mm diameter) and ePTFE were implanted in a porcine carotid artery replacement model. The fibrin-laden porous milieu facilitated rapid endothelization by the transmural angiogenesis in the NanoGraft. In-vivo patency of NanoGrafts was 100% at 2- and 4-weeks, with no changes over time in lumen size, flow velocities, and minimal foreign-body inflammatory reaction. However, the patency of ePTFE at 2-week was 66% and showed marked infiltration, neointimal thickening, and poor host tissue integration. The study demonstrates the in-vivo feasibility and safety of a thin-layered vascular prosthesis, viz., NanoGraft, and its potential superiority over the commercial ePTFE.

AB - Globally, millions of patients are affected by myocardial infarction or lower limb gangrene/amputation due to atherosclerosis. Available surgical treatment based on vein and synthetic grafts provides sub-optimal benefits. We engineered a highly flexible and mechanically robust nanotextile-based vascular graft (NanoGraft) by interweaving nanofibrous threads of poly-L-lactic acid to address the unmet need. The NanoGrafts were rendered impervious with selective fibrin deposition in the micropores by pre-clotting. The pre-clotted NanoGrafts (4 mm diameter) and ePTFE were implanted in a porcine carotid artery replacement model. The fibrin-laden porous milieu facilitated rapid endothelization by the transmural angiogenesis in the NanoGraft. In-vivo patency of NanoGrafts was 100% at 2- and 4-weeks, with no changes over time in lumen size, flow velocities, and minimal foreign-body inflammatory reaction. However, the patency of ePTFE at 2-week was 66% and showed marked infiltration, neointimal thickening, and poor host tissue integration. The study demonstrates the in-vivo feasibility and safety of a thin-layered vascular prosthesis, viz., NanoGraft, and its potential superiority over the commercial ePTFE.

KW - Nanotextile

KW - Small diameter vascular grafts

KW - Endothelialisation

KW - Nanofibers

KW - Electrospinning

KW - In-vivo feasibility

KW - Coronary surgery

KW - Vascular surgery

KW - Nanotextile vascular prosthesis

KW - Vascular graft failure

KW - Tissue engineering

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DO - 10.1186/s12951-022-01268-1

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SN - 1477-3155

VL - 20

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JO - Journal of Nanobiotechnology

JF - Journal of Nanobiotechnology

IS - 1

M1 - 71

ER -

A novel small diameter nanotextile arterial graft is associated with surgical feasibility and safety and increased transmural endothelial ingrowth in pig

Abstract

Bibliographical note

Keywords

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