Crosslinked acellular saphenous vein for small-diameter vascular graft

Ramesh, Balasundari; Mathapati, Santosh; Galla, Satish; Cherian, Kotturathu Mammen; Guhathakurta, Soma

doi:10.1177/0218492312454019

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…S1). Exclusion of duplicates and then systematic screening of title and abstract using the Covidence platform revealed 321 studies, which was finally limited by thorough text reading to 68 studies based on inclusion criteria . These studies represented a total of 873 grafts: 258 occluded and 615 patent grafts at the end of the evaluation period.…”

Section: Resultsmentioning

confidence: 99%

Concise Review: Patency of Small-Diameter Tissue-Engineered Vascular Grafts: A Meta-Analysis of Preclinical Trials

Skovrind

Harvald

Belling

et al. 2019

Stem Cells Translational Medicine

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Several patient groups undergoing small‐diameter (<6 mm) vessel bypass surgery have limited autologous vessels for use as grafts. Tissue‐engineered vascular grafts (TEVG) have been suggested as an alternative, but the ideal TEVG remains to be generated, and a systematic overview and meta‐analysis of clinically relevant studies is lacking. We systematically searched PubMed and Embase databases for (pre)clinical trials and identified three clinical and 68 preclinical trials ([>rabbit]; 873 TEVGs) meeting the inclusion criteria. Preclinical trials represented low to medium risk of bias, and binary logistic regression revealed that patency was significantly affected by recellularization, TEVG length, TEVG diameter, surface modification, and preconditioning. In contrast, scaffold types were less important. The patency was 63.5%, 89%, and 100% for TEVGs with a median diameter of 3 mm, 4 mm, and 5 mm, respectively. In the group of recellularized TEVGs, patency was not improved by using smooth muscle cells in addition to endothelial cells nor affected by the endothelial origin, but seems to benefit from a long‐term (46–240 hours) recellularization time. Finally, data showed that median TEVG length (5 cm) and median follow‐up (56 days) used in preclinical settings are relatively inadequate for direct clinical translation. In conclusion, our data imply that future studies should consider a TEVG design that at least includes endothelial recellularization and bioreactor preconditioning, and we suggest that more standard guidelines for testing and reporting TEVGs in large animals should be considered to enable interstudy comparisons and favor a robust and reproducible outcome as well as clinical translation.

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Section: Resultsmentioning

confidence: 99%

Concise Review: Patency of Small-Diameter Tissue-Engineered Vascular Grafts: A Meta-Analysis of Preclinical Trials

Skovrind

Harvald

Belling

et al. 2019

Stem Cells Translational Medicine

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“…However, the existing tissue engineering approaches still lack the ability to construct native blood vessel–like structures with multilayered vascular walls. Almost all of the artificial blood vessels display a homogeneous state, whether it is a polymer blood vessel, an acellular blood vessel, a self‐assembled vascular graft, or a biosynthetic vascular graft . Bilayered or multilayered electrospinning is used to mimic the structure of native blood vessels, but some shortcomings of pure polymer still exist, such as intimal hyperplasia, thrombosis, calcification, and chronic inflammation .…”

Section: Discussionmentioning

confidence: 99%

Design, Preparation, and Performance of a Novel Bilayer Tissue‐Engineered Small‐Diameter Vascular Graft

Ran

et al. 2018

Macromolecular Bioscience

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In clinical practice, the need for small‐diameter vascular grafts continues to increase. Decellularized xenografts are commonly used for vascular reconstructive procedures. Here, porcine coronary arteries are decellularized, which destroys the extracellular matrix structure, leading to the decrease of vascular strength and the increase of vascular permeability. A bilayer tissue‐engineered vascular graft (BTEV) is fabricated by electrospinning poly(l‐lactide‐co‐carprolactone)/gelatin outside of the decellularized vessels and functionalized by immobilizing heparin, which increases the biomechanical strength and anticoagulant activity of decellularized vessels. The biosafety and efficacy of the heparin‐modified BTEVs (HBTEVs) are verified by implanting in rat models. HBTEVs remain patent and display no expansion or aneurism. After 4 weeks of implantation, a cell monolayer in the internal surface and a dense middle layer have formed, and the mechanical properties of regenerated vessels are similar to those of rat abdominal aorta. Therefore, HBTEVs can be used for rapid remodeling of small‐diameter blood vessels.

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“…1 Over 700,000 coronary artery bypass graft surgeries are performed every year to restore blood flow distal to an arterial occlusion, mainly because of atherosclerosis. 10 Although autologous arterial and venous grafts are the best options as bypass graft material, about 40% of patients requiring arterial bypass surgery do not have autologous grafts of sufficient length or quality. 9 Moreover, only IMA grafts have shown promising results with high long-term patency rate, while using venous grafts, including the saphenous vein, can frequently lead to graft occlusion due to in vivo remodeling such as compliance mismatch and intimal hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

Decellularization of Human Internal Mammary Artery: Biomechanical Properties and Histopathological Evaluation

Kajbafzadeh

Khorramirouz

Kameli

et al. 2017

BioResearch Open Access

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This study undertook to create small-diameter vascular grafts and assess their structure and mechanical properties to withstand arterial implantation. Twenty samples of intact human internal mammary arteries (IMAs) were collected and decellularized using detergent-based methods. To evaluate residual cellular and extracellular matrix (ECM) components, histological analysis was performed. Moreover, collagen typing and ECM structure were analyzed by Picrosirius red and Movat's pentachrome staining. Scanning electron microscopy was also applied to assess microarchitecture of both endothelial and adventitial surfaces of native and decellularized arterial samples. Furthermore, mechanical tests were performed to evaluate the rigidity and suture strength of the arteries. Human IMAs were completely decellularized in all three segments (proximal, middle, and distal). ECM proteins such as collagen and elastic fibers were efficiently preserved and no structural distortion in intima, media, and adventitial surfaces was observed. The parameters of the mechanical tests revealed no significant differences in the mechanical properties of decellularized arteries in comparison to native arteries with considerable strength, suture retention, and stress relaxation (Young's modulus [MPa] = 0.22 ± 0.023 [native] and 0.22 ± 0.015 [acellular]; and suture strength 0.56 ± 0.19 [native] vs. 0.56 ± 0.12 [acellular], respectively). Decellularized IMA represents a potential arterial scaffold as an alternative to autologous grafts for future arterial bypass surgeries. By this technique, microarchitecture and mechanical integrity of decellularized arteries were considerably similar to native arteries. The goal of this study was to introduce an efficient method for complete decellularization of human IMA and evaluate the ECM and biomechanical properties.

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Crosslinked acellular saphenous vein for small-diameter vascular graft

Abstract: Crosslinking after decellularization by the dye-mediated photooxidation method could be reproduced in any human vein to obtain a small-diameter vascular grafts.

Cited by 9 publications

References 17 publications

Concise Review: Patency of Small-Diameter Tissue-Engineered Vascular Grafts: A Meta-Analysis of Preclinical Trials

Concise Review: Patency of Small-Diameter Tissue-Engineered Vascular Grafts: A Meta-Analysis of Preclinical Trials

Design, Preparation, and Performance of a Novel Bilayer Tissue‐Engineered Small‐Diameter Vascular Graft

Decellularization of Human Internal Mammary Artery: Biomechanical Properties and Histopathological Evaluation

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