Novel bioresorbable adhesive patch for treatment of aortic dissection

Aorta being the largest blood vessel in the body often damaged in cardiovascular diseases. Dissections involving the ascending aorta and aortic arch have traditionally been managed entirely by surgery, while dissections beyond the arch vessels have most commonly been relegated to medical management. Endovascular repair of aortic dissection still presents significant limitations. Preserving the mechanical and biological properties set by the aortic microstructure is critical to the success of implantable grafts.

In the current study, researchers present the performance of an adhesive bioresorbable patch designed to cover the entry tear of aortic dissections. They demonstrate the power of using a biomimetic scaffold in a vascular environment. The findings are published in Journal of American College of Cardiology.

The key findings are

• The researchers used a two-faced polycaprolactone patches that were electrospun. The luminal face consisted of aligned fibers designed to align with blood flow, to promote endothelial cell migration and to stop underlying smooth muscle cell colonization.

• The abluminal face of the patch was comprised of random fibers with high porosity, aimed at promoting smooth muscle cell colonization and macrophage clustering. This structure guarantees full integration within the native vascular tissue, promoting differential colonization by endothelial and smooth muscle cells.

• Mimicking the aorta’s mechanical properties is critical to avoid mechanical mismatches and consequent device failure. The mechanical testing indicates that the patch design is able to mimic those properties, and echocardiographic measurements validate that indeed they met the range of natural tissue properties, because the patch was fully compliant with the natural motion of the aorta.

• Patch and adhesive biocompatibility was assessed in vivo and ex vivo. The patch-adhesive system did not cause any thrombogenicity in standardized tests. Cytotoxicity was very low in vitro, and animal studies showed minimal to no inflammation and thrombogenicity up to 90 days in large animals. Together, these results show that neither the patch nor the adhesive compromise cell viability.

Researchers ended “A novel bioresorbable adhesive patch to treat aortic dissections has been developed and validated in vivo. The patch does not present biocompatibility issues and initiates a natural integration in the tissue. Further studies in humans are necessary for its final validation.”

Reference: Balà N, Aranda A, Teixidó P, et al. In Vivo Efficacy of an Adhesive Bioresorbable Patch to Treat Aortic Dissections. J Am Coll Cardiol Basic Trans Science. null2023, 0 (0) .https://doi.org/10.1016/j.jacbts.2023.08.002.