Current status of prosthetic bypass grafts: A review

Kannan, Ruben Y.; Salacinski, Henryk J.; Butler, Peter E. M.; Hamilton, George; Seifalian, Alexander M.

doi:10.1002/jbm.b.30247

Cited by 474 publications

(380 citation statements)

References 123 publications

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“…1 Synthetic materials are well known to perform poorly in small-diameter ( < 6 mm) coronary and peripheral artery bypass applications typically because of acute thrombogenicity of the graft and anastomotic intimal hyperplasia, compounded by minimal spontaneous endothelialization. 2 Autologous vessels, which are the standard of care at present, are of limited quantity, especially in patients with diffuse atherosclerosis who have had previous bypass procedures. 1 Various approaches have been used to fabricate TEVG, [3][4][5][6][7][8][9] recently reviewed.…”

Section: Introductionmentioning

confidence: 99%

Implantation of Completely Biological Engineered Grafts Following Decellularization into the Sheep Femoral Artery

Syedain

Meier

Lahti

et al. 2014

Tissue Engineering Part A

126

108

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The performance of completely biological, decellularized engineered allografts in a sheep model was evaluated to establish clinical potential of these unique arterial allografts. The 4-mm-diameter, 2-3-cm-long grafts were fabricated from fibrin gel remodeled into an aligned tissue tube in vitro by ovine dermal fibroblasts. Decellularization and subsequent storage had little effect on graft properties, with burst pressure exceeding 4000 mmHg and the same compliance as the ovine femoral artery. Grafts were implanted interpositionally in the femoral artery of six sheep (n = 9), with contralateral sham controls (n = 3). At 8 weeks (n = 5) and 24 weeks (n = 4), all grafts were patent and showed no evidence of dilatation or mineralization. Mid-graft lumen diameter was unchanged. Extensive recellularization occurred, with most cells expressing aSMA. Endothelialization was complete by 24 weeks with elastin deposition evident. These completely biological grafts possessed circumferential alignment/mechanical anisotropy characteristic of native arteries and were cultured only 5 weeks prior to decellularization and storage as ''off-the-shelf'' grafts.

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Section: Introductionmentioning

confidence: 99%

Implantation of Completely Biological Engineered Grafts Following Decellularization into the Sheep Femoral Artery

Syedain

Meier

Lahti

et al. 2014

Tissue Engineering Part A

126

108

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“…When small caliber (ø < 6 mm) blood vessels have to be replaced and autologous substitutes are unavailable, synthetic grafts do not represent a long-term alternative and other options have to be considered [2][3][4][5]. Scaffold-based vascular tissue engineering (VTE) proposes to combine cells and scaffolding systems in order to obtain vascular constructs [4].…”

Section: Introductionmentioning

confidence: 99%

Tailoring Mechanical Properties of Collagen-Based Scaffolds for Vascular Tissue Engineering: The Effects of pH, Temperature and Ionic Strength on Gelation

2010

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Collagen gels have been widely studied for applications in tissue engineering because of their biological implications. Considering their use as scaffolds for vascular tissue engineering, the main limitation has always been related to their low mechanical properties. During the process of in vitro self-assembly, which leads to collagen gelation, the size of the fibrils, their chemical interactions, as well as the resulting microstructure are regulated by three main experimental conditions: pH, ionic strength and temperature. In this work, these three parameters were modulated in order to increase the mechanical properties of collagen gels. The effects on the gelation process were assessed by turbidimetric and scanning electron microscopy analyses. Turbidity measurements showed that gelation was affected by all three factors and scanning electron images confirmed that major changes occurred at the microstructural level. Mechanical tests showed that the compressive and tensile moduli increased by four-and three-fold, respectively, compared to the control. Finally, viability tests confirmed that these gels are suitable as scaffolds for cellular adhesion and proliferation.

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“…Prosthetic vascular grafts are widely used in these reconstructive operations, but revisions are often necessary because of their inability to grow or effectively remodel within a growing child (1)(2)(3). A strategy to address this issue is the use of living tissue-engineered vascular grafts (TEVGs).…”

mentioning

confidence: 99%

Tissue-engineered vascular grafts transform into mature blood vessels via an inflammation-mediated process of vascular remodeling

Roh

Sawh-Martinez

Brennan

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

503

499

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Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are the earliest tissue-engineered vascular grafts (TEVGs) to be used clinically. These TEVGs transform into living blood vessels in vivo, with an endothelial cell (EC) lining invested by smooth muscle cells (SMCs); however, the process by which this occurs is unclear. To test if the seeded BMCs differentiate into the mature vascular cells of the neovessel, we implanted an immunodeficient mouse recipient with human BMC (hBMC)-seeded scaffolds. As in humans, TEVGs implanted in a mouse host as venous interposition grafts gradually transformed into living blood vessels over a 6-month time course. Seeded hBMCs, however, were no longer detectable within a few days of implantation. Instead, scaffolds were initially repopulated by mouse monocytes and subsequently repopulated by mouse SMCs and ECs. Seeded BMCs secreted significant amounts of monocyte chemoattractant protein-1 and increased early monocyte recruitment. These findings suggest TEVGs transform into functional neovessels via an inflammatory process of vascular remodeling.bone marrow | monocyte chemoattractant protein-1 | tissue engineering | neovascularization C ongenital heart disease is a leading cause of infant mortality, often requiring early surgical intervention to correct fatal cardiovascular malformations. Prosthetic vascular grafts are widely used in these reconstructive operations, but revisions are often necessary because of their inability to grow or effectively remodel within a growing child (1-3). A strategy to address this issue is the use of living tissue-engineered vascular grafts (TEVGs). Constructed from biodegradable polyester tubes seeded with autologous bone marrow mononuclear cells (BMCs), these grafts undergo extensive remodeling in animal recipients and appear to transform into living blood vessels, similar in morphology and function to the native veins into which they are interposed (4, 5). Ongoing clinical studies evaluating BMC-seeded grafts as venous conduits for congenital heart surgery report excellent safety profiles and 100% patency rates at 1-3 years of follow-up (6-8). Additionally, these grafts demonstrate growth potential, suggesting they may be more effective for the pediatric patient population than currently available vascular grafts (8,9).Although the functional efficacy and clinical utility of TEVGs are promising, little is known about how these BMC-seeded polyester tubes transform into living blood vessels in host recipients. It has been proposed that stem cells within the seeded BMC population differentiate into the endothelial cells (ECs) and smooth muscle cells (SMCs) of the developing neovessel, ultimately replacing the degrading polyester tube (10). This hypothesis, however, has not been directly examined.We recently developed a method for constructing small-diameter biodegradable synthetic scaffolds suitable for use as vascular grafts in mice (11). These tubular scaffolds are composed of the same materials and design used in clinical TEVGs...

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Current status of prosthetic bypass grafts: A review

Cited by 474 publications

References 123 publications

Implantation of Completely Biological Engineered Grafts Following Decellularization into the Sheep Femoral Artery

Implantation of Completely Biological Engineered Grafts Following Decellularization into the Sheep Femoral Artery

Tailoring Mechanical Properties of Collagen-Based Scaffolds for Vascular Tissue Engineering: The Effects of pH, Temperature and Ionic Strength on Gelation

Tissue-engineered vascular grafts transform into mature blood vessels via an inflammation-mediated process of vascular remodeling

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