The Genoa Vascular Biobank: A Today Resource for Future Perspectives in Vascular Research

Abstract

Background: Biological knowledge and patient care have been significantly improved by the emergence of big data analysis and -omics sciences, requiring high quality standards for biospecimen and data collection. Biobanks are complex and dynamic units designated to fulfill these needs.

Objectives: The Genoa Vascular Biobank (GTB-VD) is a collaborative network between the IRCCS Ospedale Policlinico San Martino (Centre of Biological Resources), and the University of Genoa (Vascular and Endovascular Surgery Unit; Anatomic Pathology Unit; Laboratory of Clinical and Experimental Vascular Biology). This work describes workflow, ethic and governance requirements, demographic and clinical characteristics of subjects enrolled in the GTB-VD, and the volume of open or endovascular surgical interventions.

Design: The GTB-VD recruits patients undergoing surgical repair for carotid artery stenosis (CS) and abdominal aortic aneurysm (AAA), enrolled on the basis of selection criteria and subdivided for pathology and type of intervention, upon informed consent.

Methods: Biospecimens comprise serum, plasma, whole blood, peripheral blood mononuclear cells, and urine (from AAA only), stored at -80°C; lesions from open surgeries are frozen and formalin fixed paraffin embedded. Samples are associated with donor's clinical data through pseudonymization to prevent patient identification. Data accuracy and sample quality are ensured by harmonized standard operative procedures.

Results: From 2018 to the end of 2023, 442 CS (distinguished into severe-asymptomatic or symptomatic, displaying a ratio of 5:1) and 214 AAA have been collected. CS is more frequently associated with diabetes and peripheral artery diseases, AAA with pulmonary history, and renal function impairment. Open surgery is more used for CS and endovascular for AAA.

Conclusion: The GTB-VD, as organized, represents an "unicum" in our Country; it supports studies to identify molecular targets and biomarkers associated with specific arteriopathy, for developing secondary prevention strategies and minimally invasive, in situ therapies. Collaborative studies and sample sharing are welcome.

Keywords: Vascular surgery; abdominal aortic aneurysm; carotid artery stenosis; vascular biobank workflow.

Figure 1.

Schematic representation of carotid bifurcation and internal carotid artery, showing parameters to measure the degree of carotid stenosis on arterial angiography (A). Intraoperative images of carotid artery endarterectomy by eversion and reimplantation. (B-E): exposure of a carotid bifurcation with internal and external carotid artery (B); transected internal carotid artery: the vessel is straightened and the atherosclerotic plaque visualized. (C); Removal of the plaque by eversion. (D) transected internal carotid artery without the atherosclerotic plaque (E) Images are provided from our Unit of Vascular and Endovascular Surgery.

Figure 2.

Open surgery: aorto-aortic graft for aneurysm repair (left panel); Intraoperative angiography of an endovascular aortic aneurysm repair (EVAR; right panel). Images are provided by our Unit of Vascular and Endovascular Surgery.

Figure 3.

(A) Flowchart of vascular sample processing. Carotid plaque: lesion from patients with high/moderate-graded carotid symptomatic stenosis or with severe carotid asymptomatic stenosis; AAA: aortic wall from patients with abdominal aortic aneurysm FFPE: Formalin-Fixed Paraffin-Embedded; OCT: Optimal cutting temperature used to embed tissue samples prior to frozen sectioning on a microtome-cryostat; H&E: hematoxylin-eosin staining; Movat: Monat pentachrome staining; WB: Whole Blood; PBMCs: peripheral blood mononuclear cell. (B) Criteria for carotid plaque dissection and storage. When recognizable, the lesion is oriented according to the bloodstream: section 1, comprehending the core (in the middle) and the shoulder (at both sides), FFPE; sections 2 and 3, comprehending mostly plaque shoulder an, the core of the upstream portion of the plaque, are stored at −80°C. Often, the arterial wall (left side) and the inner side containing the plaque (right side) are divided into complementary fragments.