Realtime monitoring of thrombus formation in vivo using a self-reporting vascular access graft.
Realtime monitoring of thrombus formation in vivo using a self-reporting vascular access graft.
复制标题
使用自我报告血管通路移植物实时监测体内血栓形成。
DOI：
10.1038/s43856-024-00436-8
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Hoare D
中科院分区：
文献类型：
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作者：
Hoare D
慢性肾脏疾病(CKD)影响着全球10%的人口，每年造成超过1000亿美元的损失，并导致心血管疾病风险增加。许多慢性肾脏病患者需要定期进行血液透析。人造动静脉移植物(AVG)越来越多地被用来为透析提供快速的血管连接。最初，它们有很好的通畅率，但严重受限于静脉吻合口的新生内膜增生，这会导致随后的血栓形成、移植物失败和死亡。方法在这里，我们描述了一种系统，在该系统中，电阻抗频谱传感器被周向结合到合成动静脉移植物的壁上。这与植入式无线电遥测系统相结合，用于向患者外部传输数据。该系统使用单层血管内皮细胞和平滑肌细胞，以及带有移植的人颈动脉斑块的猪血和凝块进行测试。然后在体外进行传感器测试，并将该设备植入雌性猪体内。结果该设备可以无线报告生物材料的积累，包括细胞和血液。当将对照与病理性动脉粥样硬化进行比较时，也可以检测到差异。在猪身上，移植物的堵塞形成之间的差异是远程获得的，并被无线报告。结论结合电阻抗频谱和植入式无线电遥测系统可以实现移植物监测。这有可能用于在体内实时早期检测静脉狭窄和血栓形成。原则上，这一概念也适用于其他心血管疾病和血管植入设备。
BackgroundChronic kidney disease (CKD) affects 10% of the global population costing over a hundred billion dollars per annum and leading to increased risk of cardiovascular disease. Many patients with CKD require regular haemodialyses. Synthetic arteriovenous grafts (AVG) are increasingly used to provide rapid vascular connection for dialysis. Initially, they have excellent patency rates but are critically limited by neointimal hyperplasia at the venous anastomosis, which drives subsequent thrombosis, graft failure and death.MethodsHere, we describe a system in which electrical impedance spectroscopy sensors are incorporated circumferentially into the wall of a synthetic arteriovenous graft. This is combined with an implantable radiotelemetry system for data transmission outside the patient. The system was tested using monolayers of endothelial and smooth muscle cells as well as swine blood and clots with explanted human carotid artery plaques. Sensor testing was then performed in vitro and the device was implanted in vivo in female swine.ResultsThe device can wirelessly report the accumulation of biological material, both cells and blood. Differences are also detected when comparing controls with pathological atheroma. In swine differences between blockage formation in a graft were remotely obtained and wireless reported.ConclusionsCombining electrical impedance spectroscopy and an implantable radiotelemetry system enables graft surveillance. This has the potential to be used for early detection of venous stenosis and blood clot formation in real-time in vivo. In principle, the concept could apply to other cardiovascular diseases and vascular implantable devices.