Experimental Vascular Graft Using Small‐Caliber Fascia‐Wrapped Fibrocollagenous Tube: Short‐Term Evaluation

Abstract

This study was undertaken to evaluate the application of autogenous fascia as a framework for a fibrocollagen tube for small-caliber vascular prostheses in Japanese white rabbits (n = 15). The fascia, measuring 10 x 40 mm, was harvested from the dorsal fascia and was carefully wrapped around a silicone rod of 1.5 mm in diameter. Then, the fascia-wrapped silicone rod was implanted into a subcutaneous pocket on the medial thigh. Four weeks later, the fascia-wrapped silicone rod was removed from the subcutaneous pocket. The rod was removed from the material, and the fascia-wrapped fibrocollagen tube was treated to make it antithrombogenic. Subsequently, the 1.5 x 10-mm fascia-wrapped tube was prepared as an arterial conduit. Using microvascular techniques, the tube was interposed into the divided femoral artery. Eleven of 15 grafts maintained patency over the follow-up period and no aneurysmal formation was found at any graft site. Microscopically, there was an ingrowth of endothelium with fibroblast proliferation from each end of the recipient vessel at 2 weeks after interposition; however, no neointima was found to line the center of the conduit. At 5 weeks after interposition, the neointimal growth rate was 70 percent. There was an ingrowth of endothelium with fibroblast proliferation from each end onto the entire internal surface of the conduit at 8 weeks after interposition. Further study is required before any long-term conclusions can be drawn.

Animal models for the assessment of novel vascular conduits

“…Rabbits provide a useful model for the assessment of small-diameter conduits, being able to accommodate a range of conduit sizes across different locations: aortoiliac bypass (up to 5-mm diameter), 38 aortic interposition (3-4 mm), 39,136-139 carotid interposition (generally 2 mm) 78,140-142 and femoral interposition (1-1.5 mm), [143][144][145] with lengths up to 4 or 5 cm in most locations. For carotid and femoral procedures, other advantages include simple anesthesia and the availability of bilateral implantation.…”

Utilizing the Foreign Body Response to Grow Tissue Engineered Blood Vessels in Vivo

“…However, intimal hyperplasia was reported at both ends of the TEBV of 70% of the lumen, yet not in the center of the TEBV. This would indicate an increased proliferation of cells near both anastomoses likely as a result of the turbulent flow [16]. …”

“…Monolayer of endothelium. Elastin like mesh seen.1085 mmHgIntroduction sheeth usedInteresting presence of elastinYamanami et al [71]Type C – mold systemDorsum - subcutaneousArgatroban610 mmFemale BeaglesFemoral artery end-to-endultrasonographyOriginal: biotube 33%Type C: 100%7 daysFibroblasts and collagen.Elastin present.Thick, collagen rich, elastin present.Original: biotube 944 mmHgType C: 1825 mmHgImprovement over original designFurukoshi et al [15]Silicone, fasciaMedial thigh - subcutaneousFascia covered1510 mmFemale Japanese white rabbitsFemoral artery end-to-endMilking test60%80%80%2 weeks5 weeks8 weeks-Fibroblast, endothelium ingrowth.-Interesting concept to incorporate dorsal fasciaTsukagoshi et al [16]PEOT/PBT 55/45Abdomen - subcutaneousChloroform etching880 mmFemale landrace pigsCarotid artery bilateral, end-to-endAngiography88%4 weeks(myo-)fibroblasts, ECM, some luminal macrophages.Predominantly desmin (+) SMC like cells, no leukocytes, Monolayer of endothelium, some elastin positivity.5211,04 mmHg (derived burst pressure)Biomaterial surface modification to tailor FBRRothuizen et al [14]α- SMA, alpha-smooth muscle actin; SMC, smooth muscle cell; vim, vimentin; des, desmin; FBR, foreign body response …”

“…Campbell et al already showed an elegant approach to this problem by lining the luminal side of the TEBV with autologous mesothelial cells [58]. Despite the difficulty of seeding an endothelium upon TEBV’s prior to grafting, all studies using the in vivo grafts have shown endothelialization of the lumen [14, 16, 59, 71]. Although, the function of endothelial progenitor cells is decreased in patients with chronic kidney disease [76].…”

Biomatériaux vasculaires : du génie biologique et médical au génie tissulaire

“…E. Allaire et al [30] réticulent chimiquement une matrice aortique décellularisée et l'ensemencent avec des cellules musculaires lisses vasculaires. La matrice de collagène fibrillaire peut être obtenue à partir d'uretère bovin réticulé chimiquement [31], de fascia musculaire dorsal chez le lapin [32] ou de sous-muqueuse intestinale implantée en position artérielle [33]. Ces sources tissulaires semblent donc présenter un intérêt comme substitut vasculaire.…”