Medical textiles as vascular implants and their success to mimic natural arteries

Vascular implants belong to a specialised class of medical textiles. The basic purpose of a vascular implant (graft and stent) is to act as an artificial conduit or substitute for a diseased artery. However, the long-term healing function depends on its ability to mimic the mechanical and biological behaviour of the artery. This requires a thorough understanding of the structure and function of an artery, which can then be translated into a synthetic structure based on the capabilities of the manufacturing method utilised. Common textile manufacturing techniques, such as weaving, knitting, braiding, and electrospinning, are frequently used to design vascular implants for research and commercial purposes for the past decades. However, the ability to match attributes of a vascular substitute to those of a native artery still remains a challenge. The synthetic implants have been found to cause disturbance in biological, biomechanical, and hemodynamic parameters at the implant site, which has been widely attributed to their structural design. In this work, we reviewed the design aspect of textile vascular implants and compared them to the structure of a natural artery as a basis for assessing the level of success as an implant. The outcome of this work is expected to encourage future design strategies for developing improved long lasting vascular implants.

Avaliação do estresse oxidativo induzido por superfícies de titânio

Commercially pure Titanium (cp Ti) is a material largely used in orthopedic and dental implants due to its biocompatibility properties. Changes in the surface of cp Ti can determine the functional response of the cells such as facilitating implant fixation and stabilization, and increased roughness of the surface has been shown to improve adhesion and cellular proliferation. Various surface modification methods have been developed to increase roughness, such as mechanical, chemical, electrochemical and plasma treatment. An argon plasma treatment generates a surface that has good mechanical proprieties without chemical composition modification. Besides the topography, biological responses to the implant contribute significantly to its success. Oxidative stress induced by the biomaterials is considered one of the major causes of implant failure. For this reason the oxidative potential of titanium surfaces subjected to plasma treatment was evaluated on this work. CHO-k1 cells were cultivated on smooth or roughed Ti disks, and after three days, the redox balance was investigated measuring reactive oxygen species (ROS) generation, total antioxidant capacity and biomarkers of ROS attack. The results showed cells grown on titanium surfaces are subjected to intracellular oxidative stress due to hydrogen peroxide generation. Titanium discs subjected to the plasma treatment induced less oxidative stress than the untreated ones, which resulted in improved cellular ability. Our data suggest that plasma treated titanium may be a more biocompatible biomaterial.

Growth of Calcium Phosphate Using Chemically Treated Titanium Oxide Nanotubes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Ximelagatran versus warfarin for prophylaxis of venous thromboembolism in major orthopedic surgery: systematic review of randomized controlled trials

INTRODUÇÃO: O ximelagatrano foi recentemente estudada para profilaxia do tromboembolismo venoso (TEV). OBJETIVO: Avaliar se o ximelagatrano comparado com a varfarina melhora a profilaxia do TEV em pacientes submetidos à cirurgia ortopédica do joelho. FONTE DE DADOS: Estudos randomizados identificados por pesquisa eletrônica na literatura médica, até 2006, cujos dados foram compilados no programa Review Manager, versão 4.2.5. RESULTADOS: Foram incluídos três estudos randomizados bem conduzidos envolvendo 4.914 participantes. Foram definidos dois sub-grupos com dosagens diferentes de ximelagatrano (24 mg and 36 mg, duas vezes ao dia). O tratamento com ximelagatrano mostrou freqüência significantemente menor de TEV que o tratamento com varfarina, mas somente na dosagem de 36-mg [risco relativo, RR 0.72 ([intervalo de confiança, IC, 95% 0.64, 0.81), p < 0.00001]. A freqüência de TEV no sub-grupo de 24-mg foi similar a da varfarina [RR 0.86 (IC 95% 0.73, 1.01), p = 0.06]. Para TEV maior, embolia pulmonar, sangramento e sangramento maior não houve diferença entre varfarina e a ximelagatrano. Ao final do tratamento, a elevação da alanino-aminotransferase (ALT) foi menos freqüente no sub-grupo de 24 mg de ximelagatrano que no grupo da varfarina [RR 0.33 (IC 95% 0.12, 0.91) p = 0.03], mas no período de acompanhamento essa elevação foi maior com 36 mg de ximelagatrano [RR 6.97 (IC 95% 1.26, 38.50) p = 0.03]. CONCLUSÃO: O ximelagatrano foi mais efetivo que a varfarina quando usado em dosagens maiores (36 mg, 2 vezes ao dia), mas às expensas de aumento de enzimas hepáticas no período de acompanhamento.

Extraocular muscle fixation to porous polyethylene orbital implants using 2-octyl-cyanoacrylate

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Assessment of mechanical properties and dimensions of suture threads utilized in orthopedic surgeries

Fios de sutura de náilon (0, 3-0 e 4-0), poliéster trançado (0, 3-0 e 4-0) e polipropileno (0, 3-0 e 4-0) de 7 marcas comercializadas no Brasil, foram submetidos a análise de diâmetro, comprimento, resistência do encastoamento, resistência à tração do fio sem nó e resistência à tração do fio com nó, segundo metodologia padronizada pela Associação Brasileira de Normas Técnicas (ABNT). Os resultados obtidos indicam que a maioria dos fios testados encontra-se dentro dos valores preconizados pela ABNT.

The influence of external ultrasound on the histologic architecture of the organic capsule around smooth silicone implants: Experimental study in rats

Background Capsular contracture is the main complication related to breast silicone implants, and its prevention remains a medical challenge. The authors present experimental research examining the effect of external ultrasound on the formation and contracture of peri-implant capsules.Methods In this study, 42 male Wistar rats had a 2-mm smooth surface implant placed in a dorsal submuscular pocket. They then were separated into ultrasound'' and control'' groups that received repeated external applications either with or without the ultrasound power on. Ultrasound applications were given three times a week for a period of 90 days. After that, both groups were housed under the same conditions with no application scheduled. Five animals of each group, killed at 30, 60, 90, and 180 days, had their implants removed along with the capsule, which received a special histologic preparation via annular sectioning that provided wide circumferential observation of the capsular tissue. Sections were stained with hematoxylin/eosin stain, Masson's trichrome stain, and Pricrosirius Red stain for regular microscopic evaluation under normal and polarized light.Results Histologic data showed that capsules from the ultrasound and control groups had statistically significant differences. Ultrasound application developed a capsular architecture similar to that shown within textured silicone implants, and its effect had an early definition with subsequent stabilization.Conclusion The authors conclude that early and repeated external ultrasound application enhances the thickness, cellular count, and vascularity of smooth silicone capsular tissue, whereas it diminishes the pattern of parallel orientation of collagen fibers.

Gel and porous polyethylene implants for anophthalmic cavity reconstruction-evaluation using the B scan ultrasound

AIM: To evaluate the host response of the gel and porous polyethylene implants in anophthalmic cavities using the B scan ultrasound.METHODS: Thirty-six white rabbits underwent unilateral enucleation with placement of gel or porous polyethylene spheres implants. The animals were submitted to clinical examination weekly and to ultrasound evaluation on 30, 60 and 90 days after surgery.RESULTS: All rabbits with gel polyethylene spheres, except one, showed implant extrusion probably because the gel spheres have hydrated and increased in volume. The B ultrasound of the gel polyethylene implant did not show vessels inside during the following period. Five animals (27.8%) with porous polyethylene spheres presented implant extrusion after 30 days of surgery. According to B ultrasound, the porous polyethylene implant showed irregular and heterogeneous architecture and reflective peaks similar to vascularized tissues.CONCLUSION: More studies are required to determine the ideal volume of gel polyethylene implant necessary to correct the diminished orbital content in the anophthalmic cavity. The B ultrasound effectiveness showed in this study for anophthalmic socket implants evaluation provides useful information for further in vivo studies and might substitute expensive methods of implants vascularization evaluation,

Genotoxicity of corrosion eluates obtained from endosseous implants

Purpose: Commercially pure titanium alloys are currently used as metallic biomaterials in implantology. Corrosion phenomena appear to play a decisive role in metallic implant long-term behavior. Thus, the goal of this study was to examine the genotoxic potential of corrosion eluates obtained from dental implants using Chinese ovary hamster cells in vitro by the single-cell gel (comet) assay. This technique detects deoxyribonucleic acid strand breaks in individual cells in alkaline conditions.Materials and Methods: the materials tested included 3 dental implants commercially available. Each of the tested materials was corroded in a solution consisting of equal amounts of acetic acid and sodium chloride (0.1 M) for 1, 3, 7, 14, and 21 days. The Chinese ovary hamster cultures were then exposed to all corrosion eluates obtained from endosseous dental implants for 30 minutes at 37 degrees C.Results: None of the eluates was found to exhibit genotoxicity, regardless of the type of dental implant used.Conclusion: the results suggest that all dental implants tested in this study did not induce deoxyribonucleic acid breakage as depicted by the single-cell gel (comet) assay.

Comparison of synthetic hydroxyapatite and porous polyethylene implants in eviscerated rabbit eyes

Purpose: Synthetic hydroxyapatite and porous polyethylene (Polipore) spheres were placed in rabbits' eviscerated cavities to evaluate tissue reaction and volume maintenance.Methods. Fifty-six Norfolk albino rabbits underwent unilateral evisceration and implantation of synthetic hydroxyapatite (H group, 28 animals) or porous polyethylene spheres (P group, 28 animals). Postoperative reactions, animal behavior, and socket conditions were monitored. Light microscopy and morphometric evaluation with statistical analysis of the exenterated orbits were performed at 7, 15, 30, 60, 90, 120, and 180 days. Scanning electron microscopy was appraised 7, 60, and 180 days after surgery.Results: Two animals from the H group and 1 from the P group had extrusion 7 days after surgery. Throughout the experimental period, the synthetic hydroxyapatite caused more inflammation than the porous polyethylene material. Ingrowth in the sphere occurred 7 to 15 days after the surgery in both groups, and the tissue reaction became denser at approximate to60 to 90 days, when bony metaplasia began in the H group. Volume maintenance was better in the P group and with a smaller pseudocapsule surrounding the implanted sphere than in the H group.Conclusions: Clinical findings demonstrated mild inflammation inside the sphere and in the pseudocapsule surrounding it and better cavity volume maintenance in the P group animals. The authors consider porous polyethylene a more suitable material than synthetic hydroxyapatite for use in anophthalmic cavity reconstruction.

Reuse of norgestomet implants in an eCG-based superovulation protocol administered to Nelore (Bos taurus indicus) cows

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Lack of influence of the Schneiderian membrane in forming new bone apical to implants simultaneously installed with sinus floor elevation: an experimental study in monkeys

Aim: To describe the early healing processes around the implants installed after elevation of the sinus mucosa applying the lateral access technique without the use of grafting material.Material and methods: Immediately after the elevation of the maxillary sinus Schneiderian membrane by the lateral approach in eight monkeys, implants were installed without the use of grafting material. The healing of the tissue around the implants was evaluated after 4, 10, 20 and 30 days. Ground sections were prepared and analyzed histologically.Results: After 4 days of healing, the formation of coagulum and provisional matrix was documented within the elevated area. At 10-day interval, sprouts of woven bone were in continuity with the parent bone, and partly in contact with the implant surface at the base of the augmented area. While bone-to-implant contact increased after 20 and 30 days, the area underneath the Schneiderian membrane appeared reduced in volume and condensed toward the apex of the implants. The sinus mucosa was to some extent collapsed onto the implant surface and on the newly formed bone.Conclusions: The void initially occupied by the coagulum after sinus membrane elevation shrank substantially during the observation period. A lack of influence of the Schneiderian membrane in bone formation apical to implants was documented in the early phase of healing.

Evaluation of Torque Maintenance of Abutment and Cylinder Screws With Morse Taper Implants

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Surface and Biomechanical Study of Titanium Implants Modified by Laser With and Without Hydroxyapatite Coating, in Rabbits

Surface and biomechanical analysis of titanium implant surfaces modified by laser beam with and without hydroxyapatite. Titanium implants with 3 different surfaces were inserted into the tibias of 30 rabbits: group I (GI) machined surface (control group), group II irradiated with laser (GII), and group III irradiated with laser and hydroxyapatite coating applied-biomimetic method (GIII). Topographical analysis with scanning electron microscopy was made before surgery in the tibia. These rabbits were distributed into 2 periods of observation: 4 and 8 weeks postsurgery, after which biomechanical analysis (removal torque) was conducted. Statistical analysis used the Student-Newman-Keuls method. Surface showed roughness in GII and GIII. Biomechanical analysis demonstrated values with significant differences in GII and GIII. Titanium implants modified by laser irradiation can increase osseointegration during the initial phase.