Browsing by Author "Panchendrabose, Kapilan"
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Item Open Access Evaluation of in vivo endothelialization of VEGF coated stents with allogeneic mesenchymal stem cells(2020-07-15) Panchendrabose, Kapilan; Mitha, Alim Pyarali A.; Biernaskie, Jeff A.; Jones, Steven J. M.Deploying bare metal stents in the brain is a widely used procedure to repair damaged blood vessels for pathologies including aneurysms, vessel dissections and atherosclerosis. However, the major complication of this procedure is a stroke, which can occur in up to 11% of cases. The cause of the stroke is typically due to platelet interactions with the foreign material leading to blood clot formation also known as in-stent thrombosis. Current standard of care intracranial stents are significantly thrombogenic and require patients to remain on lifelong antiplatelet medications, which can lead to other health complications and be a financial burden for both the patient and the healthcare system. A possibility to mitigate in-stent thrombosis is the rapid formation of a new inner lining of the stent through the process of endothelialization, which conceals the foreign material from platelets. To promote rapid endothelialization, mesenchymal stem cells (MSCs) are a promising cell type. MSCs are a type of multipotent stem cell that have the capability to differentiate into cells lining the blood vessel wall or produce cytokines that can lead to endothelial formation. MSCs are naturally found in small numbers in the circulating blood of mammals, and previous research has suggested that the presence of vascular endothelial growth factor (VEGF) can augment the vasculogenic and angiogenic capabilities of MSCs. In this thesis, we developed biologically modified stents with VEGF coatings to recruit exogenously administered MSCs and compared them to several control groups, including bare metal stents which are currently in clinical use. In vitro experiments were used to determine translatability of the stent coating technique to in vivo trials, and animal studies were performed to evaluate our innovative method in terms of neointima formation and thrombus burden. Our results demonstrated that the protein coating made up of VEGF and PLGA (poly lactic-co-glycolic acid) is significantly retained after catheter delivery, and MSCs may be attracted to the coating. We also showed that VEGF and MSCs, VEGF alone and that MSCs alone significantly improve endothelialization but do not necessarily deter thrombus formation compared to uncoated controls. These studies can potentially solve a major problem associated with vascular stent implantation and provide the initial translational work needed for commercializationItem Open Access The utility of three-dimensional modeling and printing in pediatric surgical patient and family education: a systematic review(2024-01-03) Yang, Angela; Panchendrabose, Kapilan; Leong, Cameron; Raza, Syed S.; Joharifard, ShahrzadAbstract Background Three-dimensional (3D) modeling and printing are increasingly being used in surgical settings. This technology has several applications including pre-operative surgical planning, inter-team communication, and patient education and counseling. The majority of research on 3D technology has focused on adult populations, where it has been found to be a useful tool for educating patients across various surgical specialties. There is a dearth, however, of research on the utility of 3D modeling and printing for patient and family education in pediatric populations. Our objective was to systematically review the current literature on how this modality is being utilized in pediatric surgical settings for patient and family education and counselling. Methods We conducted a systematic review in accordance with PRISMA and CASP guidelines. The MEDLINE, CINAHL, Embase, and Web of Science databases were searched from inception to October 21, 2023, with no restrictions on language or geographical location. Citation chaining was used to ensure relevant papers were included. Articles were doubly screened and data was extracted independently by two authors. In the case of disagreement, a third author was consulted. Any articles pertaining to 3D modeling and printing in pediatric surgical settings for patient and family education and counseling were included. Results Six articles met inclusion criteria and were used for qualitative analysis. Two involved questionnaires given to parents of children to assess their understanding of relevant anatomy, surgical procedure, and risks after viewing conventional CT images and again after viewing a 3D-printed model. One involved a quasi-experimental study to assess young patients’ pre-operative surgical understanding and anxiety after undergoing conventional teaching as compared to after viewing a 3D storybook. One involved questionnaires given to parents of children in control and study groups to assess the usefulness of 3D printed models compared to conventional CT images in their understanding of relevant anatomy and the surgical procedure. Another study looked at the usefulness of 3D printed models compared to 2D and 3D CT images in providing caregiver understanding during the pre-operative consent process. The last article involved studying the impact of using 3D printing to help patients understand their disease and participate in decision-making processes during surgical consultations. In all six studies, utilizing 3D technology improved transfer of information between surgical team members and their patients and families. Conclusion Our systematic review suggests that 3D modeling and printing is a useful tool for patient and family education and counselling in pediatric surgical populations. Given the very small number of published studies, further research is needed to better define the utility of this technology in pediatric settings.