Replacement of the Canine Inferior Vena Cava with a Seeded Graft

Shimizu, Masayuki; Suzuki, Sohei; Takaya, Shunichi; Satoh, Kei

doi:10.1007/s005950170133

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…159 In another study, a 6 mm Dacron graft coated with gelatin and seeded with autologous ECs were implanted into the vena cava of a canine model which similarly showed no thrombus formation. 179 Human trials of endothelialized vascular implants according to the procedures stated above have been investigated. A randomized clinical study was conducted up to 7 years using fibronectin-coated e-PTFE grafts, which was in-vitro lined with autologous ECs, showed higher performance (75.8%) compared to control (0%) and grafts lined with ECs only (66%).…”

Section: Protein Coatingmentioning

confidence: 99%

Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review

Obiweluozor

Emechebe

Kim

et al. 2020

Cardiovasc Eng Tech

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Background-Current design strategies for small diameter vascular grafts (< 6 mm internal diameter; ID) are focused on mimicking native vascular tissue because the commercially available grafts still fail at small diameters, notably due to development of intimal hyperplasia and thrombosis. To overcome these challenges, various design approaches, material selection, and surface modification strategies have been employed to improve the patency of small-diameter grafts. Review-The purpose of this review is to outline various considerations in the development of small-diameter vascular grafts, including material choice, surface modifications to enhance biocompatibility/endothelialization, and mechanical properties of the graft, that are currently being implanted. Additionally, we have taken into account the general vascular physiology, tissue engineering approaches, and collective achievements of the authors in this area. We reviewed both commercially available synthetic grafts (e-PTFE and PET), elastic polymers such as polyurethane and biodegradable and bioresorbable materials. We included naturally occurring materials by focusing on their potential application in the development of future vascular alternatives. Conclusion-Until now, there are few comprehensive reviews regarding considerations in the design of small-diameter vascular grafts in the literature. Here-in, we have discussed in-depth the various strategies employed to generate engineered vascular graft due to their high demand for vascular surgeries. While some TEVG design strategies have shown greater potential in contrast to autologous or synthetic ePTFE conduits, many are still hindered by high production cost which prevents their widespread adoption. Nonetheless, as tissue engineers continue to develop on their strategies and procedures for improved TEVGs, soon, a reliable engineered graft will be available in the market. Hence, we anticipate a viable TEVG with resorbable property, fabricated via electrospinning approach to hold a greater potential that can overcome the challenges observed in both autologous and allogenic grafts. This is because they can be mechanically tuned, incorporated/surface-functionalized with bioactive molecules and mass-manufactured in a reproducible manner. It is also found that most of the success in engineered vascular graft approaching commercialization is for large vessels rather than small-diameter grafts used as cardiovascular bypass grafts. Consequently, the field of vascular engineering is still available for future innovators that can take up the challenge to create a functional arterial substitute.

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Section: Protein Coatingmentioning

confidence: 99%

Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review

Obiweluozor

Emechebe

Kim

et al. 2020

Cardiovasc Eng Tech

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“…After 30 days, the inner fibrous capsule in Dacron grafts was significantly thicker as compared to ePTFE grafts (Herring et al, 1984). Shimizu et al (2001) implanted EC-seeded and nonseeded gelatin-coated Dacron grafts into dogs. Four experimental groups were created by including anti-platelet treatment.…”

Section: Poolementioning

confidence: 99%

Endothelialization of Small-Diameter Vascular Prostheses

Zijpp¹,

A.A.²,

Feijen³

2003

Archives of Physiology and Biochemistry

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In the field of arterial vascular reconstructions there is an increasing need for functional small-diameter artificial grafts (inner diameter < 6 mm). When autologous replacement vessels are not available, for example because of the bad condition of the vascular system in the patient, the surgeon has no other alternative than to implant a synthetic polymerbased vessel. After implantation the initial major problem concerning these vessels is the almost immediate occlusion, due to blood coagulation and platelet deposition, under the relatively low flow conditions. As the search for the perfect bio-inert polymer has not revealed a material with suitable properties for this application, improved performance of small-diameter artificial blood vessels is now being sought in the biological field. The poor blood-compatibility of an artificial vascular graft is not simply because of its coagulation-stimulating or platelet-activating properties, but more due to its inability to actively participate in the prevention of blood coagulation and platelet deposition. As these functions are naturally performed by endothelial cells, the utilization of these cells seems inevitable for the construction of a functional small-diameter artificial blood vessels. This review describes the current status of the use of endothelial cells to improve the performance of artificial vascular prostheses.

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“…Both in vitro [23] and in vivo [24] studies comparing the thrombogenicity of Dacron with PTFE have shown that Dacron leads to the deposition of more fibrin and platelets. In animal studies with Dacron over the last 18 years, some have tried seeding the graft with endothelial cells to enhance patency in the venous system, with some statistically significant success recently, but no clinical trials as yet [22,25–27].…”

Section: Commentmentioning

confidence: 99%

Transitional cell carcinoma of the kidney invading the inferior vena cava, treated by excision and grafting, with a review of vena cava replacement

et al. 2003

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surgeon to remove part or all of the IVC [2]. In one case with complete obstruction of the IVC on venography before surgery the vena cava was excised from the level of the left renal vein down to the common iliac veins, and the natural collateral circulation via paravertebral and lumbar veins relied upon [3]. No comment was made about limb swelling after surgery, apart from the patient being alive and well 1 year afterward. In one case involving thrombectomy only with thrombus extending to the hepatic veins, a cardiopulmonary bypass and hypothermic circulatory arrest was used [4]. IVC INVOLVEMENTRenal cell cancers may involve the IVC in up to 10% of cases and the experience of operating on the IVC in a urological context arises from this area of surgery. It is seldom necessary to graft the IVC [5], but if the caval wall is invaded and there are few collaterals it may be required. Some indication as to whether or not the wall of the IVC is invaded may be gained from the diameter of the thrombus. A small study on 18 patients found that in all seven with an IVC diameter of ≥ 40 mm on CT there was extensive macroscopic and microscopic tumour invasion of the caval vessel wall at operation. In these cases the caval wall was resected with or without a synthetic PTFE patch graft. By comparison, in only two of 11 patients with a caval diameter of <40 mm was there vessel wall invasion requiring patch-grafting [6]. IVC GRAFTSThe first experimental attempts at grafting the vena cava were by Carrel and Guthrie in the early 1900s. In an extensive review in 1974, Scherck et al. [7] noted that prosthetic replacement of veins was too unreliable for routine clinical application, because the patency rates in animal models were inconsistent or low. The lowest success rates were in the infrarenal IVC and maintaining patency at this level became the focus of experimental work. The best success rates in experimental models in the 1950s and 1960s were with autologous artery and vein grafts, 46% of which were patent at follow-up. Synthetic grafts of Dacron or unexpanded PTFE had a 62% patency rate if an arteriovenous fistula was used. The latter were introduced by Stansel [8] in 1964, as a way of increasing flow through the graft. By contrast polyester or unexpanded PTFE grafts with no fistulae had patency rates of only 15% and 9%. However, this 15% patency rate for polyester was based on only 10 animals, and all these patency rates were based on numerous small and uncontrolled experiments. The article concluded that caval replacement was still a difficult and unsolved problem. PTFEIn 1972 the first animal experiments with expanded PTFE (Gore-Tex™) in the venous system appeared; in the arterial system the early ordinary PTFE grafts had aneurysmal dilatation. Gore-Tex has the inner extrusion supported by a thin outer membrane of higher density PTFE that gives greater bunting and suture holding strength [9]. No arteriovenous anastomosis or long-term anticoagulation was used. Patency rates in the IVC were high, in seven of nine piglets at 2...

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Replacement of the Canine Inferior Vena Cava with a Seeded Graft

Cited by 4 publications

References 15 publications

Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review

Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review

Endothelialization of Small-Diameter Vascular Prostheses

Transitional cell carcinoma of the kidney invading the inferior vena cava, treated by excision and grafting, with a review of vena cava replacement

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