This is not for CCSVI, but for valves in chronic venous insufficiency of the legs. It sounds like they are transplanting valves made from porcine small intestines, making some sort of bioprosthetic valve? What caught my eye also is that they are also harvesting endothelial cells and then lining the valve with endothelial cells and this is preventing intimal hyperplasia.Syllabus Contributions for Distinguished Abstract: Improved Bioprosthetic Valve for the Treatment of Chronic Deep Venous Insufficiency Using an Autologous Endothelial Layer by Dusan Pavcnik
Percutaneous transcatheter implantation of porcine small intestine submucosa (SIS) bioprosthetic valves has been reported as a treatment for chronic deep venous insufficiency. Endothelial progenitor outgrowths cells (EOCs), isolated from whole ovine blood, were evaluated as a source of in vitro autologous seeding for SIS endothelialization. Retention of the EOC monolayer was evaluated to test the feasibility of delivering an endotheliolized SIS valve.2. Objectives At the conclusion of this session, the attendee will be able to (minimum of 3):1. To be familiar with recent studies showing that leaflets pre-seeded with mature endothelial cells (ECs) prevented thrombus and IH from forming on the leaflets and enhanced valve functionality.
2. To have general notions that endothelial progenitor cells (EPCs) are being used as a source of autologous ECs, due to their ease of isolation from circulating blood.
3. To know the criteria for testing the retention of the endothelial layer through loading and delivery, in vitro and ex vivo flow.
3. Topic OutlineA percutaneously implantable bioprosthetic venous valve that remains functional over time is an attractive alternative to direct valvular reconstruction or transplantation. Animal studies demonstrated that leaflets lined with endothelial cells prevented IH, thereby prolonging valve functionality. Critical issues in using percutaneous valve therapy are the source of endothelial cells for harvest in patients and the ability to deliver the valve leaflet with its endothelium intact and fully functioning.
4. ReferencesPavcnik D Percutaneous Management of Deep Venous Reflux: Review of experimental work and clinical experience with bioprosthetic valve. JVM 2008; 13:75
Teebken OE Tissue-engineered bioprosthetic venous valve: Study in sheep. Eur J VES 2003; 25: 305
Pavcnik D Percutaneous Autologous Venous Valve Transplantation: Feasibility Study in an ovine model. JVS 2007; 46: 338
Hinds, M Potential of baboon endothelial progenitor cells for tissue engineered endografts. Biomed Mater Res 2008; 86: 804
Could a CCSVI stent be lined with endothelial cells, or would they be damaged when the stent is implanted?
This is for the future!