Development of novel drug-eluting biodegradable nano-fiber for prevention of postoperative pulmonary venous obstruction

Interact Cardiovasc Thorac Surg. 2009 Apr;8(4):402-6; discussion 406-7. doi: 10.1510/icvts.2008.192831. Epub 2009 Jan 12.

Abstract

Pulmonary venous obstruction (PVO) after correction of total anomalous pulmonary venous connection (TAPVC) frequently occurs due to intimal-hyperplasia and the required re-operation. We have developed a novel sustained-release drug delivery system, using Tacrolimus-eluting biodegradable nano-fiber (TEBN). It consists of nano-scale fiber composed of biodegradable polymer and Tacrolimus. This study evaluated the effects of TEBN for prevention of venous anastomotic stricture in a rat model to apply to PVO operation. Tacrolimus was incorporated into poly (L-lactide-co-glycolide). The venous stricture model was made by rat inferior vena cava anastomosis. The IVC anastomosis was covered with TEBN with 1.0 wt% Tacrolimus (n=12) or without TEBN as a control (n=12), and evaluated histologically at 1, 2, and 4 weeks after operation. The ratio of intimal area was significantly reduced in the TEBN group compared with the control group (ratio; 1 week: 0.43+/-0.26 vs. 0.07+/-0.04, P=0.04, 2 weeks: 0.39+/-0.19 vs. 0.05+/-0.02, P=0.01, 4 weeks: 0.31+/-0.15 vs. 0.09+/-0.04, P=0.03, control vs. TEBN, respectively). Histological findings showed endothelialization along the inner surface of the vein even in TEBN. The TEBN reduced intimal hyperplasia and preserved endothelialization even in a venous stricture. These results suggested that this strategy might be useful for prevention of recurrent PVO after TAPVC correction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants*
  • Anastomosis, Surgical
  • Animals
  • Cardiovascular Agents / administration & dosage*
  • Cell Proliferation / drug effects
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Drug-Eluting Stents*
  • Humans
  • Hyperplasia
  • Male
  • Materials Testing
  • Muscle, Smooth, Vascular / drug effects
  • Muscle, Smooth, Vascular / pathology
  • Nanostructures*
  • Polyglactin 910*
  • Prosthesis Design
  • Pulmonary Veno-Occlusive Disease / etiology
  • Pulmonary Veno-Occlusive Disease / pathology
  • Pulmonary Veno-Occlusive Disease / prevention & control*
  • Rats
  • Rats, Wistar
  • Tacrolimus / administration & dosage*
  • Time Factors
  • Tunica Intima / drug effects
  • Tunica Intima / pathology
  • Vena Cava, Inferior / drug effects*
  • Vena Cava, Inferior / pathology
  • Vena Cava, Inferior / surgery

Substances

  • Cardiovascular Agents
  • Polyglactin 910
  • Tacrolimus