Tolerance and Long-term MRI Imaging of Gadolinium-modified Meshes Used in Soft Organ Repair

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Mar 27

PMID 25811855

Citations 2

Authors

Vincent Letouzey

Stephanie Huberlant

Arnaud Cornille

Sebastien Blanquer

Olivier Guillaume

Laurent Lemaire

Xavier Garric

Renaud de Tayrac

Affiliations

Soon will be listed here.

Abstract

Background: Synthetic meshes are frequently used to reinforce soft tissues. The aim of this translational study is to evaluate tolerance and long-term MRI visibility of two recently developed Gadolinium-modified meshes in a rat animal model.

Materials And Methods: Gadolinium-poly-ε-caprolactone (Gd-PCL) and Gadolinium-polymethylacrylate (Gd-PMA) modified meshes were implanted in Wistar rats and their tolerance was assessed daily. Inflammation and biocompatibility of the implants were assessed by histology and immunohistochemistry after 30 days post implantation. Implants were visualised by 7T and 3T MRI at day 30 and at day 90. Diffusion of Gadolinium in the tissues of the implanted animals was assessed by Inductively Coupled Plasma Mass Spectrometry.

Results: Overall Gd-PMA coated implants were better tolerated as compared to those coated with Gd-PCL. In fact, Gd-PMA implants were characterised by a high ratio collagen I/III and good vascularisation of the integration tissues. High resolution images of the coated mesh were obtained in vivo with experimental 7T as well as 3T clinical MRI. Mass spectrometry analyses showed that levels of Gadolinium in animals implanted with coated mesh were similar to those of the control group.

Conclusions: Meshes coated with Gd-PMA are better tolerated as compared to those coated with Gd-PCL as no signs of erosion or significant inflammation were detected at 30 days post implantation. Also, Gd-PMA coated meshes were clearly visualised with both 7T and 3T MRI devices. This new technique of mesh optimisation may represent a valuable tool in soft tissue repair and management.

Citing Articles

Can magnetisation transfer magnetic resonance imaging help for the follow-up of synthetic hernia composite meshes fate? A pilot study.

Franconi F, Lefranc O, Radlovic A, Lemaire L MAGMA. 2022; 35(6):1021-1029.

PMID: 35552915 DOI: 10.1007/s10334-022-01016-4.

Shape memory polymers with enhanced visibility for magnetic resonance- and X-ray imaging modalities.

Weems A, Szafron J, Easley A, Herting S, Smolen J, Maitland D Acta Biomater. 2017; 54:45-57.

PMID: 28259837 PMC: 5811198. DOI: 10.1016/j.actbio.2017.02.045.

References

Guillaume O, Blanquer S, Letouzey V, Cornille A, Huberlant S, Lemaire L . Permanent polymer coating for in vivo MRI visualization of tissue reinforcement prostheses. Macromol Biosci. 2012; 12(10):1364-74. DOI: 10.1002/mabi.201200208. View

Alt C, Brocker K, Lenz F, Sohn C, Kauczor H, Hallscheidt P . MRI findings before and after prolapse surgery. Acta Radiol. 2013; 55(4):495-504. DOI: 10.1177/0284185113497201. View

Mamy L, Letouzey V, Lavigne J, Garric X, Gondry J, Mares P . Correlation between shrinkage and infection of implanted synthetic meshes using an animal model of mesh infection. Int Urogynecol J. 2010; 22(1):47-52. DOI: 10.1007/s00192-010-1245-7. View

Wolstenholme J . Use of commercial dacron fabric in the repair of inguinal hernias and abdominal wall defects. AMA Arch Surg. 1956; 73(6):1004-8. DOI: 10.1001/archsurg.1956.01280060104024. View

Bellon J, Garcia-Carranza A, Garcia-Honduvilla N, Carrera-San Martin A, Bujan J . Tissue integration and biomechanical behaviour of contaminated experimental polypropylene and expanded polytetrafluoroethylene implants. Br J Surg. 2004; 91(4):489-94. DOI: 10.1002/bjs.4451. View

Fischer T, Ladurner R, Gangkofer A, Mussack T, Reiser M, Lienemann A . Functional cine MRI of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair: initial results. Eur Radiol. 2007; 17(12):3123-9. DOI: 10.1007/s00330-007-0678-y. View

Ali S, Zhong S, Doherty P, Williams D . Mechanisms of polymer degradation in implantable devices. I. Poly(caprolactone). Biomaterials. 1993; 14(9):648-56. DOI: 10.1016/0142-9612(93)90063-8. View

Birch C, Fynes M . The role of synthetic and biological prostheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol. 2002; 14(5):527-35. DOI: 10.1097/00001703-200210000-00015. View

Maher C, Baessler K, Glazener C, Adams E, Hagen S . Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2007; (3):CD004014. DOI: 10.1002/14651858.CD004014.pub3. View

10.

de Tayrac R, Letouzey V . Basic science and clinical aspects of mesh infection in pelvic floor reconstructive surgery. Int Urogynecol J. 2011; 22(7):775-80. DOI: 10.1007/s00192-011-1405-4. View

11.

White G, Gibby W, Tweedle M . Comparison of Gd(DTPA-BMA) (Omniscan) versus Gd(HP-DO3A) (ProHance) relative to gadolinium retention in human bone tissue by inductively coupled plasma mass spectroscopy. Invest Radiol. 2006; 41(3):272-8. DOI: 10.1097/01.rli.0000186569.32408.95. View

12.

Letouzey V, Deffieux X, Gervaise A, Mercier G, Fernandez H, de Tayrac R . Trans-vaginal cystocele repair using a tension-free polypropylene mesh: more than 5 years of follow-up. Eur J Obstet Gynecol Reprod Biol. 2010; 151(1):101-5. DOI: 10.1016/j.ejogrb.2010.03.013. View

13.

Harth K, Blatnik J, Anderson J, Jacobs M, Zeinali F, Rosen M . Effect of surgical wound classification on biologic graft performance in complex hernia repair: an experimental study. Surgery. 2012; 153(4):481-92. DOI: 10.1016/j.surg.2012.08.064. View

14.

Garcia-Moreno F, Sotomayor S, Perez-Lopez P, Perez-Kohler B, Bayon Y, Pascual G . Intraperitoneal behaviour of a new composite mesh (Parietex™ Composite Ventral Patch) designed for umbilical or epigastric hernia repair. Surg Endosc. 2014; 28(12):3479-88. DOI: 10.1007/s00464-014-3633-4. View

15.

Pascual G, Hernandez-Gascon B, Rodriguez M, Sotomayor S, Pena E, Calvo B . The long-term behavior of lightweight and heavyweight meshes used to repair abdominal wall defects is determined by the host tissue repair process provoked by the mesh. Surgery. 2012; 152(5):886-95. DOI: 10.1016/j.surg.2012.03.009. View

16.

Altman D, Vayrynen T, Ellstrom Engh M, Axelsen S, Falconer C . Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011; 364(19):1826-36. DOI: 10.1056/NEJMoa1009521. View

17.

Sivaslioglu A, Unlubilgin E, Dolen I . A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocoele. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 19(4):467-71. DOI: 10.1007/s00192-007-0465-y. View

18.

Coda A, Lamberti R, Martorana S . Classification of prosthetics used in hernia repair based on weight and biomaterial. Hernia. 2011; 16(1):9-20. DOI: 10.1007/s10029-011-0868-z. View

19.

Hansen N, Barabasch A, Distelmaier M, Ciritsis A, Kuehnert N, Otto J . First in-human magnetic resonance visualization of surgical mesh implants for inguinal hernia treatment. Invest Radiol. 2013; 48(11):770-8. DOI: 10.1097/RLI.0b013e31829806ce. View

20.

Szabo A, Haj M, Waxsman I, Eitan A . Evaluation of seprafilm and amniotic membrane as adhesion prophylaxis in mesh repair of abdominal wall hernia in rats. Eur Surg Res. 2000; 32(2):125-8. DOI: 10.1159/000008751. View