Patient trials of artificial artery
An expert team at the Royal Free has received £500,000 to take their invention of an artificial artery from the laboratory to human trials within the next year.
The team has developed a small diameter bypass graft made from a polymer material modified by nanotechnology, for use in coronary artery and lower limb arterial surgery.
The grant from the Wellcome Trust means the team, led by George Hamilton, professor of vascular surgery, and Alexander Seifalian, professor of nanotechnology and tissue repair, is one step closer to making their invention available to thousands of patients with vascular disease.
The team has developed a small diameter bypass graft made from a polymer material modified by nanotechnology, for use in coronary artery and lower limb arterial surgery. The material enables the graft to mimic the natural pulsing of a human blood vessel such as arteries delivering blood and nutrients from the heart to every cell, organ and muscle in the body.
The wall of the artery is designed to be able to withstand blood pressure throughout a person’s lifetime and is normally very strong. If it is damaged by disease such as arteriosclerosis or hardening of the arteries, the artery can become blocked, or in some patients the wall can weaken becoming an aneurysm, and it may rupture.
The current surgical treatment is to bypass or replace the damaged vessel using a plastic graft or preferably a vein taken from the patient’s own leg, but many patients do not have suitable veins.
These plastic grafts were originally made with the same nylon used to make ‘drip-dry’ shirts (Dacron), or PTFE a type of plastic noted for its non-stick properties. This type of material is suitable for larger grafts but has poor results for smaller grafts of less than 8mm, used for instance in heart bypasses. This is because these materials cannot pulse and their surfaces stimulate clotting of the blood in the graft.
Prof Hamilton said: "There is a high failure rate using these rigid small diameter bypass grafts. Many patients who have needed smaller bypass grafts but have not had suitable veins, have had limbs amputated and some patients unable to have coronary bypass surgery have had heart attacks and died.”
He added: “Led by Professor Seifalian, we have used nanotechnology to develop this material to mimic as closely as possible the natural artery. Nanotechnology involves incorporating single microscopic molecules that have important effects on the circulation into the graft material.”
“The new micro-graft pulses rhythmically to match the beat of the heart. As well as this, the new graft material is strong, flexible, resistant to blood clotting and doesn’t break down - which is a major breakthrough.”
The team also found that coating the inner lining of the new graft material with certain molecules by nano-technology, stimulated circulatory endothelial stem cells to line the graft. These cells, known for their ability to renew themselves, can help to repair the damaged blood vessel even further.
Prof Hamilton said: “This will be hugely beneficial to patients in the NHS as we will be able to reduce heart attacks, reduce amputations and ultimately save lives.”
In the long-term, Professors Hamilton and Seifalian and their team hope to develop a range of grafts, stents and devices immediately available ‘off the shelf’ to all cardiac and vascular surgeons to more successfully treat heart and blood vessel disease.
The next phase of the research is due to go to clinical trials at the end of 2010.
Alexander Seifalian is a Professional Fellow of the Institute of Nanotechnology.
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