Abstract 9372: Inhibition of Neointimal Hyperplasia With the Novel Tacrolimus Eluting Suture
Objective:Intimal hyperplasia surrounding a suture line remains the leading cause of graft failure following coronary artery bypass graft surgery and peripheral vascular bypass. Immunosuppressive drug such as tacrolimus, has been shown to inhibit the development of intimal hyperplasia. We have developed a novel drug eluting suture coated with a tacrolimus(DE-suture). The study aimed to assess the efficacy of DE-suture against intimal hyperplasia.
Methods:Tacrolimus was coated onto the surface of 7–0 PolyVinylidene DiFluoride(PVDF) suture by using a bioabsorbable polymer, that allows controlled release of the drug. In porcine model, suture experiments were randomized into the following three groups:control group;non-coated suture (n=6), low DE-suture group; containing 0.13 wt% of tacrolimus (n=6), high DE-suture group; containing 0.40 wt% of tacrolimus (n=6). Half transverse arteriotomy was performed in the femoral artery and sutured. 4 weeks after implantation, femoral arteries were harvested. Histological analyses including immunohistochemistry were performed to investigate the suture site on paraffin sections.
Results:All animals survived without any clinical evidence of limb ischemia or graft infection. Control group developed significant neointimal hyperplasia on the suture site (the ratio of intimal thickness on suture/non-suture sites; 23.0±5.0), while in the low and high DE-suture groups, neointimal area were significantly redeuced to 11.0±4.3, 8.3±3.3; P<0.05 vs control), respectively(Fig). Histological analyses demonstrated lesser medial inflammatory response and adventitial fibrosis in both DE-suture groups, compared with control group(P<0.05).
Conclusions:The tacrolimus eluting sutures significantly decreased neointimal hyperplasia in porcine model. This novel suture may be useful in both coronary artery bypass graft surgery and peripheral vascular bypass.
- © 2010 by American Heart Association, Inc.