The rates of failure after revascularization surgery are high for both vein grafts (VG) and in arterial interventions. One approach to improve outcomes is the upregulation of the gaseous transmitter‐molecule (H2S) endogenously, involving dietary restrictions on a short-term basis. However, a potential barrier in the vascular surgery is strict patient compliance. This study aims to portray a new therapeutic approach via a locally applicable gel containing hydrogen sulfide releasing prodrug (GYY) to improve arterial remodeling and mitigate graft failure.
All experiments were performed on 12 weeks old mice. The pre‐GYY mice had a 36.5% decrease in intimal by media+adventitia area ratio compared with controls. GYY‐gel treated VG had larger diameters at both postoperative days 14 and 28 and a 56.7% reduction in intimal by media+adventitia area ratios. Intimal vascular smooth muscle cell migration was observed to decrease by 30% after the GYY gel treatment reproduced in vitro. The local gel‐based treatment with the hydrogen sulfide‐donor GYY stood as a replacement therapy to improve arterial remodeling and VG durability after injury.
In conclusion, an H2S releasing gel was tested and developed, that could be applied locally during the procedure, capable of attenuating arterial remodeling and vein graft failure. Future directions will be focused on exploring its potential in endovascular interventions and vascular access surgery.
Ref: https://www.ahajournals.org/doi/10.1161/JAHA.120.016391
