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A new design concept for knitted external vein-graft support mesh

Singh, Charanpreet and Wang, Xungai 2015, A new design concept for knitted external vein-graft support mesh, Journal of the mechanical behavior of biomedical materials, vol. 48, pp. 125-133, doi: 10.1016/j.jmbbm.2015.04.001.

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Title A new design concept for knitted external vein-graft support mesh
Author(s) Singh, Charanpreet
Wang, Xungai
Journal name Journal of the mechanical behavior of biomedical materials
Volume number 48
Start page 125
End page 133
Total pages 9
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-08
ISSN 1878-0180
Keyword(s) Compliance
Coronary artery bypass graft
Knitted mesh
Segmented knitting
Vein-graft
Science & Technology
Technology
Engineering, Biomedical
Materials Science, Biomaterials
Engineering
Materials Science
SAPHENOUS-VEIN
INTIMAL HYPERPLASIA
ARTERIAL GRAFTS
MECHANICAL-PROPERTIES
CORONARY-ARTERY
NITINOL MESHES
PATENCY
SHEATH
STENT
PATHOPHYSIOLOGY
Summary Autologous vein-graft failure significantly limits the long-term efficacy of coronary artery bypass procedures. The major cause behind this complication is biomechanical mismatch between the vein and coronary artery. The implanted vein experiences a sudden increase (10-12 fold) in luminal pressures. The resulting vein over-distension or 'ballooning' initiates wall thickening phenomenon and ultimate occlusion. Therefore, a primary goal in improving the longevity of a coronary bypass procedure is to inhibit vein over-distension using mechanical constriction. The idea of using an external vein-graft support mesh has demonstrated sustained benefits and wide acceptance in experimental studies. Nitinol based knitted structures have offered more promising mechanical features than other mesh designs owing to their unique loosely looped construction. However, the conventional plain knit construction still exhibits limitations (radial compliance, deployment ease, flexibility, and bending stresses) which limit this design from proving its real clinical advantage. The new knitted mesh design presented in this study is based on the concept of composite knitting utilising high modulus (nitinol and polyester) and low modulus (polyurethane) material components. The experimental comparison of the new design with a plain knit design demonstrated significant improvement in biomechanical (compliance, flexibility, extensibility, viscoelasticity) and procedural (deployment limit) parameters. The results are indicative of the promising role of new mesh in restoring the lost compliance and pulsatility of vein-graft at high arterial pressures. This way it can assist in controlled vein-graft remodelling and stepwise restoration of vein mechanical homoeostasis. Also, improvement in deployment limit parameter offers more flexibility for a surgeon to use a wide range of vein diameters, which may otherwise be rendered unusable for a plain knit mesh.
Language eng
DOI 10.1016/j.jmbbm.2015.04.001
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073892

Document type: Journal Article
Collection: Institute for Frontier Materials
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Created: Thu, 27 Aug 2015, 15:30:01 EST

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