Vascular surgeons frequently undertake "revascularizations" to treat cardiovascular diseases, restoring blood flow to regions that have either lost it or are receiving inadequate supply. One common example is a vein graft, which involves relocating a vein from one part of the body to another, such as from the leg to the heart in heart failure patients. For those requiring dialysis due to kidney failure, a surgical procedure is used to create an arteriovenous fistula (AVF) by grafting an artery and a vein, usually in the arm. This procedure enables blood to be extracted, cleansed of toxins, and then returned to the body. Despite their necessity, these AVFs demand expensive management in patients with end-stage renal disease.

Moreover, the longevity of revascularizations is compromised over time. The surgical procedures themselves can lead to cell build-up within the vessels, eventually leading to the same issue they aim to resolve: restricted blood flow. Currently, there are no established treatment protocols for maintaining AVFs due to previous ineffective attempts. Consequently, when an AVF fails, which is often the case, patients must undergo repeated surgeries to install new ones. This repetitive cycle can extend to various body parts including both arms, legs, or the collarbone area. Now, researchers are exploring a new approach using nanomedicine, which could be a game changer for affected patients.

Researchers at UVA Health (Charlottesville, VA, USA) are developing a sophisticated method to prevent clogged transplanted veins in heart and dialysis patients, thereby reducing the frequency of surgeries. This method, called epiNanopaint, involves applying adhesive nanoparticles to the vessels during the initial surgery. These nanoparticles are infused with a drug designed to inhibit the growth of invasive cells. Their stickiness ensures they remain in place, enabling the targeted and prolonged release of the drug at the necessary site. The focus of the research is on targeting the enzyme DOT1L with drugs to prevent vessels from narrowing and optimizing the application of this painting technique for drug delivery. Success in this research could revolutionize treatment for countless patients globally.

“Our approach is like deploying tiny guards to protect blood vessels from going bad, so that there is no need to open the body over and over again to repair them,” said Lian-Wang Guo, PhD., of the University of Virginia School of Medicine’s Department of Surgery and the Robert M. Berne Cardiovascular Research Center. “It would save so much pain and money by sparing repeated surgeries.” 

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