Small Vessel Replacement by Human Umbilical Arteries With Polyelectrolyte Film-Treated ArteriesIn Vivo Behavior
Halima Kerdjoudj, PhD*,
Nicolas Berthelemy, PhD*,
Simon Rinckenbach, MD, PhD ,
Anna Kearney-Schwartz, MD, PhD ,
Karine Montagne, MD||,
Pierre Schaaf, PhD¶,
Patrick Lacolley, MD, PhD ,
Jean-François Stoltz, PhD*,
Jean-Claude Voegel, PhD# and
Patrick Menu, PhD*,*
* Group of Bioengineering (LEMTA-UMR CNRS 7563), School of Medicine, Nancy University, Vandoeuvre-lès-Nancy, France
INSERM Unité 684, Centre d'Investigation Clinique de Nancy (CIC-P 9501), School of Medicine, Nancy University, Vandoeuvre-lès-Nancy, France
INSERM Unité 684, School of Medicine, Nancy University, Vandoeuvre-lès-Nancy, France
ERT 1061, ULP Strasbourg, France
|| Department of Pathology, Hôpital de Brabois Adultes, Vandoeuvre-lès-Nancy, France
¶ Charles Sadron Institut (UPR 22, CNRS), Strasbourg Cedex, France
# INSERM Unité 595, Odontology Faculty, Louis Pasteur University, Strasbourg, France
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Figure 1 Evolution of PEM During the Entire Experimental Period
(A) Hematoxylin and eosin/safran histological investigation of (poly(allylamine hydrochloride)/poly(styrene sulfonate))3-treated arteries and untreated arteries before implantation (magnification x25). Arrows show the presence of nuclei in arterial walls. Observation with confocal laser scanning microscopy of the transversal artery section treated with PEMrho before implantation (B), at 1 week after (C), and at 12 weeks (D) after implantation (magnification x40, numerical aperture 0.8, scale bars = 75 µm). Blue asterisks indicate the lumen localization. PEM = polyelectrolyte multilayer film.
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Figure 2 Blood Velocity Profile and 2-Dimensional Echo-Doppler Graft Examination
(A) Native rabbit carotid, (B) untreated artery, and (C) polyelectrolyte multilayer film-treated human umbilical artery after 10 weeks of implantation. See Online Videos 1 and 2.
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Figure 3 SEM Images of Explanted Grafts at 1 and 12 Weeks After Implantation
Untreated artery (UnA) (A and B), with polyelectrode multilayer film (PEM)-treated (C to F) explanted arteries and fresh carotids (G). UnA (Carotid: A; human umbilical artery [HUA]: B) occluded and with pervasive thrombus (A2 and B2) after 1 week of implantation. PEM-treated arteries (Carotid: C and E; HUA: D and F) were patent until 12 weeks (C2 to F2). After 1 week, the internal surface of the treated arteries (C2 and D2) showed no adherent cells and platelets. After 12 weeks, the treated internal artery surfaces (E2 and F2) showed a similar morphology to the native carotid internal surface (G2). Original magnification x400 (A, B, C, D, E, F, G) and x1,000 (A2, B2, C2, D2, E2, F2, G2). SEM = scanning electron microscopy.
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Figure 4 Histological Examinations of Explanted Grafts at 1 and 12 Weeks After Implantation
UnA (Carotid: A, HUA: B), with PEM-treated arteries after 1 week (Carotid: C, HUA: D) or 12 weeks (Carotid: E, HUA: F). Dotted arrows indicate inflammatory reactions at adventitia after 1 week. Black arrows indicate the absence of vascular cell, and blue arrows indicate red PEM after 1 week of implantation. The von Kossa reaction (G and H) at 12 weeks performed in the explanted arteries treated with PEM indicate the absence of wall calcification. Magnification x40. Abbreviations as in Figures 1 and 3.
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Figure 5 Vascular Wall Remodeling, Cell Identification, and PEM Visualization After 12 Weeks of Implantation
(A) H&S histological examination of PEM-treated arteries. (B) Observations with confocal laser scanning microscopy (CLSM) showed the presence of PAHrho on the arterial wall surface. (C) van Gieson staining showed the presence of elastin fibers in media (purple) and collagen in adventitia (blue). (D) Immunohistochemistry demonstrated the presence of  -SMA+ cells on the arterial wall (magnification x20). (E) The CLSM observations showed the presence of PECAM-1+ cells on internal arteries surface (magnification x40, NA 0.8, scale bars = 75 µm). H&S = hematoxylin and eosin/safran; PAH = poly(allylamine hydrochloride); PECAM = platelet endothelial cell adhesion molecule; PEM = polyelectrolyte multilayer film; PSS = poly(styrene sulfonate); SMA = smooth muscle actin.
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