Ferromagnético Bare Metal stent para la captura de la célula endotelial y Retención
Summary
Nuestros objetivos eran para diseñar, fabricar y probar los stents ferromagnéticos para la captura de las células endoteliales. Diez stents fueron probados para la fractura y 10 más stents se ensayaron para determinar el magnetismo retenido. Finalmente, 10 stents se probaron in vitro y 8 más stents fueron implantados en 4 cerdos para mostrar la captura de células y la retención.
Abstract
Se necesita endotelialización rápida de los stents cardiovasculares para reducir la trombosis del stent y evitar la terapia anti-plaquetaria que puede reducir el riesgo de hemorragia. La viabilidad de utilizar fuerzas magnéticas para capturar y retener células endoteliales excrecencia (EOC) marcadas con nanopartículas de óxido de hierro súper paramagnéticas (SPION) se ha demostrado previamente. Sin embargo, esta técnica requiere el desarrollo de un stent mecánicamente funcional a partir de un material magnético y biocompatible seguido de in-vitro e in-vivo de pruebas para demostrar la endotelización rápida. Hemos desarrollado un stent débilmente ferromagnética de acero inoxidable de 2.205 duplex utilizando el diseño asistido por ordenador (CAD) y su diseño se refinó aún más el uso de análisis de elementos finitos (FEA). El diseño final del stent exhibió una deformación principal por debajo del límite de fractura del material durante rizado mecánico y expansión. Cien stents fueron fabricados y un subconjunto de ellos se utilizó para ensayos mecánicos, retained mediciones del campo magnético, estudios in vitro de captura celular, y los estudios in vivo de implantación. Diez stents fueron probados para su despliegue para verificar si sostenidas que prensa y la expansión del ciclo sin fallo. Otros 10 stents se magnetizan usando un imán fuerte neodimio y se midió su campo magnético retenido. Los stents mostraron que el magnetismo retenido era suficiente para capturar marcado con SPION EOC en nuestros estudios in vitro. Captura EOC SPION marcado y la retención se verificó en modelos animales grandes implantando 1 stent magnetizado y 1 no magnetizado stent de control en cada uno de 4 cerdos. Las arterias con stent se explantaron después de 7 días y se analizaron histológicamente. Los stents débilmente magnéticas desarrolladas en este estudio fueron capaces de atraer y retener a las células endoteliales SPION marcado que pueden promover la curación rápida.
Introduction
Patients implanted with vascular stents manufactured from thrombogenic materials like stainless steel, cobalt chromium, and platinum chromium – both bare metal stents (BMS) and drug eluting stents (DES) – need anti-platelet therapy to prevent thrombus formation. BMS heal rapidly, but are subject to late stage restenosis due to incomplete healing. DES require long term anti-platelet therapy due to delayed healing. Anti-platelet therapy administered to avoid thrombosis as a result of incomplete or delayed healing leads to increased bleeding risk and may not be suitable for certain patients1,2. An ideal stent will heal completely and quickly thus avoiding long-term anti-platelet therapy and late stage restenosis. This complete healing can only be achieved if the stent is rapidly coated with a monolayer of endothelial cells after implantation. Coating the stents with biocompatible materials such as gold or other biopolymers has been shown to improve thrombo-resistance, but none of these techniques achieved ideal blood compatibility as may be possible by coating with endothelial cells3,4.
A stent can be coated with endothelial cells post implantation by attracting circulating progenitor cells. This self-seeding technique can be achieved by utilizing ligands and antibodies. But this technique is limited by the low number of circulating endothelial progenitor cells. A promising strategy is to deliver cells directly to the stent immediately following implantation during a short period of blood flow occlusion3,5. This strategy requires a technique for rapidly capturing cells and retaining them on the stent even after restoring blood flow. We have developed a technique in which a magnetic stent is used to attract and retain magnetically-labeled endothelial cells delivered post implantation. To achieve this, a functional BMS with sufficient magnetic properties to capture and retain magnetically-labeled endothelial cells is required6.
In this paper, we discuss the methods for designing, manufacturing, and testing a 2205 stainless steel stent. The stents were designed using CAD and FEA. The manufactured stents were magnetized using a neodymium magnet and the retained magnetic field was measured using a magneto-resistance microsensor probe. We then tested the stents for magnetically-labeled cell capture in a culture dish during our in-vitro experiments. Finally, the stents were tested in-vivo by implanting magnetic and non-magnetic stents in 4 pigs and histologically analyzing the stented arteries.
Protocol
Representative Results
Discussion
Hemos desarrollado un stent magnética que puede funcionar como un stent de metal desnudo y puede atraer a las células endoteliales SPION marcado. En estudios previos relacionados con stents magnéticos, los investigadores han utilizado níquel stents recubiertos comerciales y bobinas o mallas hechas de materiales magnéticos debido a la falta de disponibilidad de un stent ferromagnético 5,10-14. Otros grupos también han utilizado la naturaleza paramagnética de stents de acero inoxidable 304-grado disponi…
Declarações
The authors have nothing to disclose.
Acknowledgements
The authors thank Tyra Witt, Cheri Mueske, Brant Newman and Dr. Peter J. Psaltis, MBBS, PhD for their valuable contributions. This study was financially supported by European Regional Development Fund – FNUSA-ICRC (No. CZ.1.05/1.100/02.0123), American Heart Association Scientist Development Grant (AHA #06-35185N), National Institutes of Health (T32HL007111) and The Grainger Innovation Fund – Grainger Foundation.
Materials
| 2205 Stainless steel | Carpenter Technology Corporation | N/A | Round bar stock material |
| Abaqus | Dassault systems | N/A | Software |
| Atropine | Prescription drug. | ||
| Clopidogrel | Commercial name: Plavix. Prescription drug. | ||
| CM-DiI | Life Technologies | V-22888 | Molecular Probes, Eugene, OR |
| Endothelial growth medium-2 | Lonza | CC-3162 | |
| Hand Held Crimping tool | Blockwise engineering | M1-RMC | |
| Hydrochloric acid (HCl) | Sigma Aldrich | MFCD00011324 | CAUTION: wear proptective equipment and handle under fume hood |
| Isoflurane anesthesia | Piramal Critical Care, Inc. | ||
| Isopropyl alcohol | Sigma Aldrich | MFCD00011674 | |
| NdFeB magnet 2" Dia x 1" thick | Amazing magnets | D1000P | Axially magnetized disc magnet with poles on flat faces |
| Over-The-Wire trifold balloon | N/A | N/A | Any commercially available OTW trifold balloon can be used |
| Phosphate buffered saline | Life Technologies | 10010-023 | Commonly known as PBS |
| Sodium Bicarbonate (NaHCO3) | Sigma Aldrich | MFCD00003528 | |
| Sodium pentobarbital | Zoetis | Commercial Name: Sleepaway (26%), FatalPlus, Beuthanasi. Controlled substance to be ordered only by licensed veternarian | |
| SolidWorks | Dassault systems | N/A | Software |
| SpinTJ-020 micro sensor | MicroMagneitcs Sensible Solutions | N/A | Long probe STJ-020 microsensor |
| SPION | Mayo Clinic | N/A | Nanoparticles synthesized internally (Ref: Lee, S. J. et al. Nanoparticles of magnetic ferric oxides encapsulated with poly(D,L latide-co-glycolide) and their applications to magnetic resonance imaging contrast agent. J Magn Magn Mater 272, 2432-2433, doi:DOI 10.1016/j.jmmm.2003.12.416 (2004)) |
| Telazol | Zoetis | Controlled substance to be ordered only by licensed veternarian | |
| Trypsin EDTA | Life Technologies | 25200-056 | Gibco, Grand Island, NY |
| Xylazine | Bayer Animal Health | Commercial name: Rompun. Controlled sunstance to be ordered only by a licensed veternarian |
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