While discussing the problems in their work that directly affect people’s lives, vascular surgeons, Dr Tomas Baltrūnas and Mindaugas Paškevičius, had an idea to create an innovative solution, which was supported by the Lithuanian Business Support Agency (LBSA).

Various uses

There is currently no vascular prosthesis in the world with a thrombogenic outer surface of the artificial vessel wall. The two surgeons noticed that blood vessels shunted with conventional artificial implants had an increased risk of becoming inflamed due to a foreign body; if the prosthesis heals faster, the risk of infections is lower and its longer functioning is ensured.

‘During repeated surgeries, it was seen that the vascular implants were not ingrown and had no interaction with the surrounding tissues. They were loose and usually surrounded by serous fluid or already covered by infection. Therefore, repeated surgeries were required to remove the prosthesis and carry out a coronary artery bypass graft surgery and sometimes, if this was not possible, the limbs had to be amputated’, says Paškevičius.

Together with the company Baltijos mediciniai sprendimai, Baltrūnas and Paškevičius submitted an application to the call for proposals under the measure ‘Intelektas. Bendri mokslo-verslo projektai’ (Intellect. Joint Science-Business Projects) and received almost EUR 100,000 in funding for the development of an artificial blood vessel wall with a thrombogenic outer surface and an anti-thrombogenic inner surface.

‘We did not create a new artificial blood vessel. Such a prosthesis has long been used in vascular surgery. Our aim was to create an outer thrombogenic surface to form a thrombus as quickly as possible on the outside and to promote the ingrowth of the surrounding tissue, thus avoiding a rejection reaction and reducing the risk of infection’, said the doctors.

Prostheses with a thrombogenic outer surface can be used in both open and endovascular procedures for the treatment of aneurysms in various locations, as well as in open surgery for the treatment of atherosclerosis in peripheral arteries.

Overcoming challenges

The developed prototype was tested with human blood. When the required thrombi (blood clots) were noticed on the outside, the prosthesis was implanted in mice and rabbits. Rabbits were chosen in particular because they are most sensitive to foreign objects in the body. Immunologists and biomedical doctors were also involved at this stage. No rejection reactions were observed.

‘The process is complicated and required a lot of knowledge and competence. The most difficult part was to figure out how to attach chemicals to the outside of the existing prosthesis without damaging the inside and to create blood clotting. The second challenge was to find the most suitable chemicals to stimulate blood clotting’, says Paškevičius.
The team consisted of PhDs Regina Jančienė and Kazimieras Algirdas Klimavičius from the Institute of Biochemistry at the VU Life Science Centre, researcher Jonas Meškauskas and angiosurgeon Mindaugas Paškevičius, and partners such as the Lithuanian Energy Institute and the biotechnology company Innovita Research were also involved.

Looking for investors

UAB Baltijos Medicininiai Sprendimai is pleased with the result achieved – the creation of an artificial blood vessel wall with a thrombogenic outer surface.

‘The greatest appreciation for the agency is the successful implementation of such projects that are significant for humanity and the opportunity to contribute to it’, said Saulius Merkys, Acting Director of the LBSA.

Currently, the company hopes to attract attention from foreign or Lithuanian investors to help it enter the global market.

‘Without the support of the LBSA, we would not have been able to implement this idea. In the future, we look forward to further cooperation with the agency, as we want to continue the project we started. We have ideas to also test the modified prosthesis on large animals. Later on, we will also start a clinical trial with volunteers. But these phases require significant additional funding’, said Paškevičius.

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