Thrombosis and intimal hyperplasia (IH) are the main factors affecting the long-term patency of small-diameter vascular grafts (SDVGs). Fabricating a confluent endothelial cell (EC) layer on surfaces with physiological elasticity to mimic vascular endothelium should be an effective strategy to prevent restenosis that is caused by thrombosis and IH. However, the vascular endothelialization process is time-consuming and always constrained by hemocompatibility of the vascular grafts, since excellent hemocompatibility could guarantee a sufficient time window for the endothelialization process. Tetramethylpyrazine (TMP)-derived polyurethane (PU) with improved hemocompatibility and accelerated endothelialization ability is synthesized by incorporating TMP moieties into PU backbones. Results show that TMP-contained PU films possess improved hemocompatibility by down-regulating platelet adhesion/activation and increasing the clotting time. Furthermore, the human umbilical vein endothelial cell (HUVEC) test demonstrates that the introduction of TMP can significantly promote HUVEC adhesion and proliferation, and thus accelerate luminal endothelialization of vascular grafts. Moreover, the TMP-containing PU films exhibit excellent biocompatibility especially for HUVECs, and their excellent, adjustable elasticity (1123%) guarantees compliance accommodation of vascular grafts. This newly synthesized TMP-containing material with multiple biological functions is expected to make up for the shortcomings of available SDVGs in clinical practice, and has significant potential in improving the long-term patency of SDVGs.
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http://dx.doi.org/10.1039/d4tb01478b | DOI Listing |
Introduction: Nicaragua is a Central American country with a high prevalence of patients with chronic kidney disease, particularly among young men. This is largely attributable to Mesoamerican nephropathy, a form of interstitial nephritis that predominantly affects young agricultural workers. While the majority of patients have access to chronic dialysis programs, a very small number have an option of receiving a renal transplant.
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St. Antonius Hospital, Nieuwegein, The Netherlands.
In many hospitals, patients undergoing cardiac surgery receive a higher amount of blood products transfusions compared to other disciplines. Blood transfusion comes with risks and drawbacks, such as increased morbidity and mortality across different patient groups, and specifically patients undergoing cardiac surgery, and high costs. Patient Blood Management (PBM) practices focus on the application of evidence based medical and surgical concepts in order to preserve the patient's own blood.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Division of Clinical Medicine, University of Sheffield, Sheffield, UK.
Objective: Patients on direct-acting oral anticoagulants (DOACs) are at high risk of perioperative bleeding complications. Intraoperative hemoadsorption is a novel strategy to reduce perioperative bleeding in patients on DOACs undergoing non-deferable cardiac surgery. The international STAR-registry reports real-world clinical outcomes associated with this application.
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Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Augustenburger Platz 1, 13353, Berlin, Germany.
Background: Hybrid coronary revascularisation benefits patients with multivessel disease, as it amalgamates the minimally invasive direct coronary artery bypass (MIDCAB) procedure and percutaneous coronary intervention (PCI). We present a 63-year-old female with triple-vessel coronary artery disease including marked ostial stenosis of the left main coronary artery, as well as moderate stenosis of the right coronary artery. The risk of death following heart surgery (EuroSCORE II) is 4.
View Article and Find Full Text PDFBMC Health Serv Res
January 2025
Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No.510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 242062, Taiwan (R.O.C.).
Revascularization therapies, such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), alleviate symptoms and treat myocardial ischemia. Patients with multivessel disease, particularly those undergoing 3-vessel PCI, are more susceptible to procedural complications, which can increase healthcare costs. Developing efficient strategies for resource allocation has become a paramount concern due to tightening healthcare budgets and the escalating costs of treating heart conditions.
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