Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation
Rates of arteriovenous fistula maturation failure are still high, especially when suboptimal size veins are used. During successful maturation, the vein undergoes lumen dilatation and medial thickening, adapting to the increased hemodynamic forces. The vascular extracellular matrix plays an importan...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/8/7571 |
| _version_ | 1797604990568628224 |
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| author | Yong He Blake Anderson Qiongyao Hu RB Hayes Kenji Huff Jim Isaacson Kevin S. Warner Hank Hauser Myles Greenberg Venita Chandra Katalin Kauser Scott A. Berceli |
| author_facet | Yong He Blake Anderson Qiongyao Hu RB Hayes Kenji Huff Jim Isaacson Kevin S. Warner Hank Hauser Myles Greenberg Venita Chandra Katalin Kauser Scott A. Berceli |
| author_sort | Yong He |
| collection | DOAJ |
| description | Rates of arteriovenous fistula maturation failure are still high, especially when suboptimal size veins are used. During successful maturation, the vein undergoes lumen dilatation and medial thickening, adapting to the increased hemodynamic forces. The vascular extracellular matrix plays an important role in regulating these adaptive changes and may be a target for promoting fistula maturation. In this study, we tested whether a device-enabled photochemical treatment of the vein prior to fistula creation facilitates maturation. Sheep cephalic veins were treated using a balloon catheter coated by a photoactivatable molecule (10-8-10 Dimer) and carrying an internal light fiber. As a result of the photochemical reaction, new covalent bonds were created during light activation among oxidizable amino acids of the vein wall matrix proteins. The treated vein lumen diameter and media area became significantly larger than the contralateral control fistula vein at 1 week (<i>p</i> = 0.035 and <i>p</i> = 0.034, respectively). There was also a higher percentage of proliferating smooth muscle cells in the treated veins than in the control veins (<i>p</i> = 0.029), without noticeable intimal hyperplasia. To prepare for the clinical testing of this treatment, we performed balloon over-dilatation of isolated human veins and found that veins can tolerate up to 66% overstretch without notable histological damage. |
| first_indexed | 2024-03-11T04:54:42Z |
| format | Article |
| id | doaj.art-0c66813cfe9d41f8baa724a6d76928e5 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T04:54:42Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-0c66813cfe9d41f8baa724a6d76928e52023-11-17T19:42:28ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-04-01248757110.3390/ijms24087571Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula MaturationYong He0Blake Anderson1Qiongyao Hu2RB Hayes3Kenji Huff4Jim Isaacson5Kevin S. Warner6Hank Hauser7Myles Greenberg8Venita Chandra9Katalin Kauser10Scott A. Berceli11Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL 32611, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USADivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL 32611, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USADivision of Vascular Surgery, Department of Surgery, Stanford University, Stanford, CA 94305, USAAlucent Biomedical Inc., Salt Lake City, UT 84108, USADivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL 32611, USARates of arteriovenous fistula maturation failure are still high, especially when suboptimal size veins are used. During successful maturation, the vein undergoes lumen dilatation and medial thickening, adapting to the increased hemodynamic forces. The vascular extracellular matrix plays an important role in regulating these adaptive changes and may be a target for promoting fistula maturation. In this study, we tested whether a device-enabled photochemical treatment of the vein prior to fistula creation facilitates maturation. Sheep cephalic veins were treated using a balloon catheter coated by a photoactivatable molecule (10-8-10 Dimer) and carrying an internal light fiber. As a result of the photochemical reaction, new covalent bonds were created during light activation among oxidizable amino acids of the vein wall matrix proteins. The treated vein lumen diameter and media area became significantly larger than the contralateral control fistula vein at 1 week (<i>p</i> = 0.035 and <i>p</i> = 0.034, respectively). There was also a higher percentage of proliferating smooth muscle cells in the treated veins than in the control veins (<i>p</i> = 0.029), without noticeable intimal hyperplasia. To prepare for the clinical testing of this treatment, we performed balloon over-dilatation of isolated human veins and found that veins can tolerate up to 66% overstretch without notable histological damage.https://www.mdpi.com/1422-0067/24/8/7571hemodialysis vascular accessarteriovenous fistula maturationnatural vascular scaffoldingvenous angioplastydrug-coated balloon10-8-10 Dimer |
| spellingShingle | Yong He Blake Anderson Qiongyao Hu RB Hayes Kenji Huff Jim Isaacson Kevin S. Warner Hank Hauser Myles Greenberg Venita Chandra Katalin Kauser Scott A. Berceli Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation International Journal of Molecular Sciences hemodialysis vascular access arteriovenous fistula maturation natural vascular scaffolding venous angioplasty drug-coated balloon 10-8-10 Dimer |
| title | Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation |
| title_full | Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation |
| title_fullStr | Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation |
| title_full_unstemmed | Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation |
| title_short | Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation |
| title_sort | photochemically aided arteriovenous fistula creation to accelerate fistula maturation |
| topic | hemodialysis vascular access arteriovenous fistula maturation natural vascular scaffolding venous angioplasty drug-coated balloon 10-8-10 Dimer |
| url | https://www.mdpi.com/1422-0067/24/8/7571 |
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