810-4 Remodeling of the Vascular Endothelium Following PTCA in Rabbit Iliac Arteries with Fibrin Adhesive/Endothelial Cell Matrix

We proposed that a possible cause of acute and chronic complications of Percutaneous Transluminal Coronary Angioplasty (PTCA) is the loss of the endothelial cell lining of the arterial wall. The objective of this study was to reattach endothelial cells to the arterial wall at the time of PTCA. We devised a unique process utilizing a delivery device whereby a fibrin adhesive reattaches endothelial cells to denuded vessel walls at the time of PTCA. Following in vitro definition of optimal conditions required forthe adhesive matrix to successfully reattach endothelial cells to an inert plastic surface and subsequent demonstration of viability of these cells after delivery through the infusion catheter system, studies were carried out on iliac arteries (n=6/group) of New Zealand White rabbits subjected to balloon angioplasty-induced endothelial cell denudation. The Wolinsky infusion balloon (USCI. C.R. Bard) and double balloon was used to deliver the fibrin adhesive/endothelial cell matrix labelled with red fluorescent dye to denuded areas over a 3-5 min period. Immediately following treatment blood was allowed to perfuse the seeded artery for four hours to expose the iliac segments with newly attached endothelial cells to physiologic shear forces. Histological examination demonstrated the ability of this novel method to circumferentially reattach the adhesive/endothelial cell matrix to 70-90% of the denuded arterial wall segments in comparison with 5-8% reattachment following seeding with endothelial cells alone. We conclude that endothelial cells can be successfully reattached to denuded vessel walls with a fibrin adhesive matrix following PTCA