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External Self-Closing Tube to Occlude a Vessel Gradually as a Therapeutic Means of Portosystemic Shunt

Authors
Kim, Tae YoungKim, Dae-HyunYoon, Jeong-KeeKim, SurimYi, Se WonOh, Won TaekPark, Ju YoungKim, Hye-SeonKang, Mi-LanLee, Jung BokSung, Hak-Joon
Issue Date
Aug-2020
Publisher
WILEY
Keywords
external vascular wall; portosystemic shunt; proinflammation; self-closing tubes; vessel occlusion
Citation
ADVANCED THERAPEUTICS, v.3, no.8
Journal Title
ADVANCED THERAPEUTICS
Volume
3
Number
8
URI
https://yscholarhub.yonsei.ac.kr/handle/2021.sw.yonsei/6596
DOI
10.1002/adtp.202000039
ISSN
2366-3987
Abstract
The vascular network to the liver can be connected abnormally during fetal development (e.g., portosystemic shunt), thus requiring a device to close the flow connection completely. Gradual vascular occlusion is particularly important, because a sudden stop in blood flow can result in portal hypertension and cause consequential damage to the small intestine. Significant progress has been made in the development of such devices (e.g., the ameroid ring constrictor and cellophane banding) as a standard treatment for this disorder. However, incomplete occlusion is a common problem. In this study, a new vascular occlusion device is developed, enabling two major functions. First, user-friendly deployment onto the external vascular wall is achieved by programming a recovery in the shape of the tube from open to closed in response to treatment with a warm saline solution (37 degrees C). Second, proinflammatory palmitic acid is released over time from the tube surface through the adventitial wall to induce gradual occlusive vascular remodeling. These unprecedented functions are demonstrated in a series of experiments on cells and rabbit veins, addressing this major issue through gradual but complete vascular occlusion over time. The external self-closing tube represents a breakthrough proof-of-concept for treatment of this rare but critical developmental disorder.
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