Percutaneous autologous venous valve transplantation: short-term feasibility study in an ovine model

BACKGROUND: Limited experience with bioprosthetic venous valve percutaneously inserted into femoral veins in 15 patients has been promising in short-term results only to show disappointing long-term results. Percutaneous autogenous venous valve (PAVV) transplantation was explored in an ovine model as a possible alternative treatment. METHODS: PAVV consisted of a vein segment containing a valve that was attached to a stent template. The stent templates (n = 9) were designed and hand made in our research laboratory. They consist of two stainless steel square stents 13 or 15 mm in diameter to fit the ovine jugular veins (JV), which ranges from 10 to 15 mm in diameter. A valve-containing segment of JV was harvested and attached with sutures and barbs inside the stent template (n = 9). The valve devices were then manually folded and front loaded inside the 4 cm chamber of the 13F delivery sheath and delivered into the contralateral JV by femoral vein approach. Transplanted PAVVs were studied by immediate and 3 months venograms. Animals were euthanized at 3 months, and jugular veins harvested to perform angioscopic evaluations in vitro. RESULTS: PAVV transplantation was successful in all nine animals. Good valve function with no reflux was observed on immediate and 3 months venograms in eight valves. The transplanted maximal JV diameter ranged from 10.2 mm to 15.4 mm (mean 13.1 +/- 1.5 mm). Venoscopic examination revealed intact, flexible, nonthickened valve leaflets in eight specimens. One PAVV exhibited normal function of one leaflet only; the other cusp was accidentally cut during the transplantation procedure. All transplanted autologous valves were free of thrombus and incorporated into the vein wall of the host vessel. CONCLUSION: This study demonstrated that autogenous valve transplants remained patent and competent without long-term anticoagulation for up to 3 months. The percutaneous autogenous venous valve may provide in future minimally invasive treatment for patients with chronic deep venous insufficiency, but long-term studies need to be done to document its continued patency and function.

A Forgotten Original or an Original Copy? On MS. Douce 387 in the Bodleian Library: Collecting Early Modern Festival Books

Focusing on one manuscript, today in the Bodleian Library, Oxford, this chapter deals with the question how early modern objects became collectable items. The manuscript is categorized as MS. Douce 387 and its name indicates that it came from the collection of Francis Douce (1757–1834), who was keeper of manuscripts in the British Museum from 1799 until 1811. MS. Douce 387 is described in the catalogue of the Douce’ian collection as the “presentation copy with coloured designs by Marten de Vos and others” of the 1595 printed festival book Descriptio publicae gratulationis … in adventu … Ernesti archiducis Austriae. This festival book, printed in Antwerp’s Plantin-Moretus press, was commissioned by the magistrate of the city of Antwerp to commemorate the Joyous Entry of Archduke Ernest of Austria from June 1594; that an “archducal copy” bound in red velvet was commissioned as well and was owned by the Archduke is know as well. However, first research showed that Oxford copy cannot be this “archducal copy” or Marten de Vos’s artist’s copy even though it is the only know version with a handwritten text and hand-drawn illustrations. It rather should be examined as something totally different altogether. The main question remains why someone then commissioned a hand made version of this festival book, something unknown for other books of this genre? Why would someone between 1600 and 1800 sit down and copy texts and prints from a collectable book? Why was there such an on-going interest in early modern festival books? Could this manuscript be the only later made copy of the “archducal volume” or is it rather a forgery made for the European collectors’ market?