Experimental evaluation of small intestinal submucosa as a microvascular graft material

Abstract

The evaluation of porcine small intestine submucosa (SIS) in a microsurgical model was conducted using an interpositional graft in the rat femoral artery. The SIS grafts were fabricated from processed porcine material that was wrapped around a glass tube and oversewn longitudinally to produce a tubular structure. Of the 42 animals studied, 7 received grafts of untreated SIS (group I), 7 of the grafts were presoaked (PSH) in heparin (Group II), 7 animals were treated with systemic heparin prior to implantation of PSH-SIS (group III), 7 animals received SIS grafts crosslinked to heparin (group IV), 7 animals received SIS grafts crosslinked to urokinase (group V), and 7 animals received untreated autologous epigastric vein grafts (group VI). Patency was assessed postoperatively and selected grafts were evaluated by histology. All SIS grafts failed to maintain patency beyond the first postoperative hour. Histologic examination of the thrombosed graft surfaces revealed a smooth luminal surface with a thick layer of attached fibrin and platelets with a central occluding thrombus. The thickness of the induced fibrin layer appears to narrow intraluminal space significantly at the microvascular level. While having excellent success at vessel diameters greater than 3 mm, and in a variety of nonporcine animal models without xenographic rejection, SIS in this model was thrombogenic despite a favorable surface morphology as demonstrated by SEM. Even with use of heparin and urokinase SIS graft thrombosis occurred.

Development and Characterization of Acellular Extracellular Matrix Scaffolds from Porcine Menisci for Use in Cartilage Tissue Engineering

“…Consequently, decellularization of biological tissues has become an attractive strategy for obtaining ECM scaffolds. A variety of acellular tissues have been used for tissue engineering, including heart valves, blood vessels, skin, tendons, ligaments, SIS, 29,46,47 UBS, and livers. 20,22 However, the decellularization of dense and compact tissues such as cartilage and meniscus remains challenging.…”

Low-Molecular-Weight Peptides Derived from Extracellular Matrix as Chemoattractants for Primary Endothelial Cells

“…A strong angiogenic response has been noted during the remodeling process that occurs when scaffolds composed of naturally occurring extracellular matrix (ECM) that are not chemically cross-linked have been used in both preclinical studies and in human clinical applications Cobb et al 1996Cobb et al , 1999Sandusky et al 1995;Prevel et al 1994Prevel et al , 1995Badylak et al 2000). Such scaffolds have been used successfully to reconstitute a variety of tissues including musculotendinous tissues Dejardin et al 2001), lower urinary tract structures Vaught et al 1996;Atala et al 1999;Dahms et al 1998;Piechota et al 1998;Probst et al 2000), skin and subcutaneous tissues (Prevel et al 1995;Allman et al 2002), and cardiovascular tissues (Badylak et al 1989;Lantz et al 1992).…”

Biologics in Rotator Cuff Surgery: Management of Rotator Cuff Tears With an Extracellular Matrix Patch

“…61 The use of ECM is also not restricted to orthopaedics. In fact, much of what is known about ECM patches is derived from other applications, including skin, 4,48,57,62 vascular grafts, 47 periosteum, 14 bladder wall, 34 and dural tears. 16 The majority of initial work has focused on SIS; however, allogeneic and xenogeneic dermal graft sources have become popular.…”