Electrospun Small-Diameter Silk Fibroin Vascular Grafts with Tuned Mechanical and Biocompatibility Properties as Tissue Engineered Scaffolds

Almost 9 million people in the U.S. have peripheral arterial disease (PAD). In severe cases of PAD, arterial bypass surgery is performed to redirect flow around the problem area. However, for many elderly patients, this surgery is not feasible using the preferred autologous grafts because of the limited availability of tissue to use for grafting, so there is a clinical need for engineered vascular grafts. Engineered grafts are intended to replace native blood vessels by manipulating biomaterials to mimic the properties of the native vessel. Despite success in large diameter cases, small diameter grafts are still prone to a number of issues such as occlusion, hyperplasia, and thrombosis. Silk fibroin is a promising biomaterial for creating vascular grafts because of its demonstrated mechanical strength and biocompatibility. Our research established a method for electrospinning the silk fibroin onto a rotating mandrel for seamless grafts. Mechanical testing, including burst pressure and tensile strength tests, compared the strength of our grafts to that of the autologous vessel. Finally, biochemical modifications, aimed at both recruiting and proliferating HUVECs on the grafts, increased cell proliferation on the grafts in vitro

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS0000479