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Obiweluozor FO, Emechebe GA, Kim DW, Cho HJ, Park CH, Kim CS, Jeong IS. Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review. Cardiovasc Eng Technol 2020; 11:495-521. [PMID: 32812139 DOI: 10.1007/s13239-020-00482-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Abstract
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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Affiliation(s)
- Francis O Obiweluozor
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea.
| | - Gladys A Emechebe
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - Do-Wan Kim
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea
| | - Hwa-Jin Cho
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea
| | - Chan Hee Park
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
- Department of Mechanical Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - Cheol Sang Kim
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
- Department of Mechanical Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - In Seok Jeong
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea.
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Influence of Washing and Sterilization on Properties of Polyurethane Coated Fabrics Used in Surgery and for Wrapping Sterile Items. Polymers (Basel) 2020; 12:polym12030642. [PMID: 32178246 PMCID: PMC7183081 DOI: 10.3390/polym12030642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 11/17/2022] Open
Abstract
The objective of this work was to determine the influence of washing and sterilization under real hospital conditions on properties of microbial barrier offered by polyurethane coated fabrics used in surgery and for wrapping sterile items. Emphasis was put on the change of surface polyurethane coating by using FTIR analysis. The permeability and durability of the microbial barrier were determined after 0, 10, and 20 washing and sterilization procedures according to previously developed methods. Bacterial endospores of the apathogenic species of the genus Bacillus Geobacillus stearothermophilus and Bacillus atrophaeus were used. Mechanical damage to medical textiles in the washing and sterilization process was determined according to standard HRN EN ISO 13914-1:2008 and associated with changes in physical and mechanical properties. Chemical changes of PU coatings were determined using FTIR analysis. The results showed an exceptionally efficient microbial barrier and its durability in all samples after 0, 10 and 20 washing and sterilization procedures and for a period of one, two and three months.
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Meng S, Mao J, Rouse EN, Le-Bel G, Bourget JM, Reed RR, Philippe E, How D, Zhang Z, Germain L, Guidoin R. The Red Kangaroo pericardium as a material source for the manufacture of percutaneous heart valves. Morphologie 2019; 103:37-47. [PMID: 30638803 DOI: 10.1016/j.morpho.2018.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/06/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The kangaroo pericardium might be considered to be a good candidate material for use in the manufacture of the leaflets of percutaneous heart valves based upon the unique lifestyle. The diet consists of herbs, forbs and strubs. The kangaroo pericardium holds an undulated structure of collagen. MATERIAL AND METHOD A Red Kangaroo was obtained after a traffic fatality and the pericardium was dissected. Four compasses were cut from four different sites: auricular (AUR), atrial (ATR), sternoperitoneal (SPL) and phrenopericardial (PPL). They were investigated by means of scanning electron microscopy, light microscopy and transmission electron microscopy. RESULTS All the samples showed dense and wavy collagen bundles without vascularisation from both the epicardium and the parietal pericardium. The AUR and the ATR were 150±25μm thick whereas the SPL and the PPL were thinner at 120±20μm. The surface of the epicardium was smooth and glistening. The filaments of collagen were well individualized without any aggregation, but the banding was poorly defined and somewhat blurry. CONCLUSION This detailed morphological analysis of the kangaroo pericardium illustrated a surface resistant to thrombosis and physical characteristics resistant to fatigue. The morphological characteristics of the kangaroo pericardium indicate that it represents an outstanding alternative to the current sources e.g., bovine and porcine. However, procurement of tissues from the wild raises supply and sanitary issues. Health concerns based upon sanitary uncertainty and reliability of supply of wild animals remain real problems.
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Affiliation(s)
- S Meng
- Chongqing Key Lab of Catalysis and Functional Organic Molecules; College of Environment and Biotechnology, Chongqing Technology and Business University, Chongqing, PR China
| | - J Mao
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - E N Rouse
- Department of Comparative Medicine, College of Veterinary of Tennessee, Knoxville, TN, USA
| | - G Le-Bel
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - J M Bourget
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - R R Reed
- Department of Comparative Medicine, College of Veterinary of Tennessee, Knoxville, TN, USA
| | - E Philippe
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - D How
- Peninsula College of Medicine and Dentistry (PCMD), Plymouth, Devon, UK
| | - Z Zhang
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - L Germain
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - R Guidoin
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada.
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Soldani G, Murzi M, Faita F, Di Lascio N, Al Kayal T, Spanò R, Canciani B, Losi P. In vivo evaluation of an elastomeric small‐diameter vascular graft reinforced with a highly flexible Nitinol mesh. J Biomed Mater Res B Appl Biomater 2018; 107:951-964. [DOI: 10.1002/jbm.b.34189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 05/22/2018] [Accepted: 06/12/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Giorgio Soldani
- Laboratory for Biomaterials & Graft TechnologyIstituto di Fisiologia Clinica CNR Massa 54100 Italy
| | - Michele Murzi
- Fondazione Toscana Gabriele Monasterio (FTGM) Massa 54100 Italy
| | - Francesco Faita
- Laboratory for Experimental UltrasoundIstituto di Fisiologia Clinica CNR Pisa 56127 Italy
| | - Nicole Di Lascio
- Laboratory for Experimental UltrasoundIstituto di Fisiologia Clinica CNR Pisa 56127 Italy
- Institute of Life SciencesScuola Superiore Sant'Anna Pisa 56127 Italy
| | - Tamer Al Kayal
- Laboratory for Biomaterials & Graft TechnologyIstituto di Fisiologia Clinica CNR Massa 54100 Italy
| | - Raffaele Spanò
- Laboratory of Regenerative MedicineDIMES, University of Genoa Genoa 16132 Italy
| | - Barbara Canciani
- Laboratory of Regenerative MedicineDIMES, University of Genoa Genoa 16132 Italy
| | - Paola Losi
- Laboratory for Biomaterials & Graft TechnologyIstituto di Fisiologia Clinica CNR Massa 54100 Italy
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Compliance properties of collagen-coated polyethylene terephthalate vascular prostheses. J Appl Biomater Funct Mater 2014; 12:163-71. [PMID: 24756779 DOI: 10.5301/jabfm.5000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Compliance mismatch between native artery and a prosthetic graft used for infrainguinal bypass is said to be a factor for graft failure. The aim of this study was to develop a technique for measuring the compliance of collagen-coated polyethylene terephthalate (PET) vascular prostheses and to analyze the influence of several key properties on the elastic behavior of the grafts. METHODS Compliance testing was performed on 3 prostheses with and without internal compliant membrane (ICM). The principle of this test was to study the dimensional changes of prostheses submitted to internal pressure from 30 to 240 mm Hg at intervals of predetermined values. RESULTS We demonstrated that the ICM created links with the inner surface of the crimps and considerably modified the graft behavior when submitted to internal pressure. The results showed that compliance properties were dependent on the wall thickness and the crimping geometry of textile vascular prostheses. Mechanical analysis predicts the circumferential tensile behavior of these arterial grafts and validates tests for measuring compliance.
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Dempsey DK, Nezarati RM, Mackey CE, Cosgriff-Hernandez EM. High compliance vascular grafts based on semi-interpenetrating networks. MACROMOLECULAR MATERIALS AND ENGINEERING 2014; 299:1455-1464. [PMID: 25601822 PMCID: PMC4296902 DOI: 10.1002/mame.201400101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Current synthetic vascular grafts have poor patency rates in small diameter applications (<6 mm) due to intimal hyperplasia arising from a compliance mismatch between the graft and native vasculature. Enormous efforts have focused on improving biomechanical properties; however, polymeric grafts are often constrained by an inverse relationship between burst pressure and compliance. We have developed a new, semi-interpenetrating network (semi-IPN) approach to improve compliance without sacrificing burst pressure. The effects of heat treatment on graft morphology, fiber architecture, and resultant biomechanical properties are presented. In addition, biomechanical properties after equilibration at physiological temperature were investigated in relation to polyurethane microstructure to better predict in vivo performance. Compliance values as high as 9.2 ± 2.7 %/mmHg x 10-4 were observed for the semi-IPN graft while also maintaining high burst pressure, 1780 ± 230 mm Hg. The high compliance of these heat-treated poly(carbonate urethane) (PCU) and semi-IPN grafts is expected to improve long-term patency rates beyond even saphenous vein autografts by preventing intimal hyperplasia. The fundamental structure-property relationships gained from this work may also be utilized to advance biomedical device designs based on thermoplastic polyurethanes.
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Affiliation(s)
- David K. Dempsey
- Department of Biomedical Engineering, Texas A&M University, 3120 TAMU, College Station, TX 77840-3120, USA
| | - Roya M. Nezarati
- Department of Biomedical Engineering, Texas A&M University, 3120 TAMU, College Station, TX 77840-3120, USA
| | - Calvin E. Mackey
- Department of Biomedical Engineering, Texas A&M University, 3120 TAMU, College Station, TX 77840-3120, USA
| | - Elizabeth M. Cosgriff-Hernandez
- Department of Biomedical Engineering, Texas A&M University, 5033 Emerging Technologies Building, 3120 TAMU, College Station, TX 77840-3120, Phone: (979) 845-1771, Fax: (979) 845-4450
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Nezarati RM, Eifert MB, Dempsey DK, Cosgriff-Hernandez E. Electrospun vascular grafts with improved compliance matching to native vessels. J Biomed Mater Res B Appl Biomater 2014; 103:313-23. [PMID: 24846218 DOI: 10.1002/jbm.b.33201] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 03/25/2014] [Accepted: 04/21/2014] [Indexed: 01/24/2023]
Abstract
Coronary artery bypass grafting is one of the most commonly performed major surgeries in the United States. Autologous vessels such as the saphenous vein are the current gold standard for treatment; however, synthetic vascular prostheses made of expanded poly(tetrafluoroethylene) or poly(ethylene terephthalate) are used when autologous vessels are unavailable. These synthetic grafts have a high failure rate in small diameter (<4 mm) applications due to rapid reocclusion via intimal hyperplasia. Current strategies to improve clinical performance are focused on preventing intimal hyperplasia by fabricating grafts with compliance and burst pressure similar to native vessels. To this end, we have developed an electrospun vascular graft from segmented polyurethanes with tunable properties by altering material chemistry and graft microarchitecture. Relationships between polyurethane tensile properties and biomechanical properties were elucidated to select polymers with desirable properties. Graft thickness, fiber tortuosity, and fiber fusions were modulated to provide additional tools for controlling graft properties. Using a combination of these strategies, a vascular graft with compliance and burst pressure exceeding the saphenous vein autograft was fabricated (compliance = 6.0 ± 0.6%/mmHg × 10(-4) , burst pressure = 2260 ± 160 mmHg). This graft is hypothesized to reduce intimal hyperplasia associated with low compliance in synthetic grafts and improve long-term clinical success. Additionally, the fundamental relationships between electrospun mesh microarchitecture and mechanical properties identified in this work can be utilized in various biomedical applications.
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Affiliation(s)
- Roya M Nezarati
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, 77843-3120
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Campos E, Branquinho J, Carreira AS, Carvalho A, Coimbra P, Ferreira P, Gil M. Designing polymeric microparticles for biomedical and industrial applications. Eur Polym J 2013. [DOI: 10.1016/j.eurpolymj.2013.04.033] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nakazawa Y, Asano A, Nakazawa CT, Tsukatani T, Asakura T. Structural characterization of silk-polyurethane composite material for biomaterials using solid-state NMR. Polym J 2012. [DOI: 10.1038/pj.2012.119] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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10
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Xie X, Eberhart A, Guidoin R, Marois Y, Douville Y, Zhang Z. Five Types of Polyurethane Vascular Grafts in Dogs: The Importance of Structural Design and Material Selection. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 21:1239-64. [DOI: 10.1163/092050609x12481751806295] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Xingyi Xie
- a Department of Polymeric Biomaterials and Artificial Organs, College of Polymer Science and Engineering, Sichuan University, Chengdu, P. R. China; Department of Surgery, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Andreas Eberhart
- b Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Robert Guidoin
- c Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Yves Marois
- d Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Yvan Douville
- e Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5
| | - Ze Zhang
- f Department of Surgery, Faculty of Medicine, Laval University; The Research Center of Saint-François d'Assise Hospital, CHUQ, 10 Espinay Street, Room E0-165, Quebec City, Quebec, Canada G1L 3L5;,
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Wippermann J. Gefäße aus Papier? ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2010. [DOI: 10.1007/s00398-010-0797-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Xu W, Zhou F, Ouyang C, Ye W, Yao M, Xu B. Mechanical properties of small-diameter polyurethane vascular grafts reinforced by weft-knitted tubular fabric. J Biomed Mater Res A 2010; 92:1-8. [PMID: 19165779 DOI: 10.1002/jbm.a.32333] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Polyester filament yarns of different Deniers were knitted into tubular fabrics with different densities and thicknesses on a specially designed weft-knitting machine. The developed tubular fabric was used to reinforce polyurethane vascular graft and thus a kind of composite vascular graft was fabricated with a small inner diameter of 4 mm. Tensile properties of the reinforced composite vascular grafts were compared with the control tubular fabric and the pure PU vascular grafts. Elasticity and strength of the reinforced vascular grafts were improved compared with the weft-knitted tubular fabrics. Strength of the reinforced composite vascular grafts was almost 5-10 times of the strength of the pure PU vascular grafts. As the PU content increased in the reinforced composite vascular grafts, the wall thickness of the vascular graft and its strength increased, but the initial modulus of the reinforced composite vascular grafts remained similar to that of the weft-knitted tubular fabric, and the PU content showed little influence on the initial modulus of the reinforced composite vascular grafts. Microporous structure can also be fabricated in the wall of the reinforced composite vascular grafts.
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Affiliation(s)
- Weilin Xu
- Hubei New Textile and Its Application Key Laboratory, Wuhan University of Science and Engineering, Wuhan 430073, People's Republic of China
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Zilla P, Bezuidenhout D, Human P. Prosthetic vascular grafts: Wrong models, wrong questions and no healing. Biomaterials 2007; 28:5009-27. [PMID: 17688939 DOI: 10.1016/j.biomaterials.2007.07.017] [Citation(s) in RCA: 360] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Accepted: 07/06/2007] [Indexed: 12/20/2022]
Abstract
In humans, prosthetic vascular grafts remain largely without an endothelium, even after decades of implantation. While this shortcoming does not affect the clinical performance of large bore prostheses in aortic or iliac position, it contributes significantly to the high failure rate of small- to medium-sized grafts (SMGs). For decades intensive but largely futile research efforts have been under way to address this issue. In spite of the abundance of previous studies, a broad analysis of biological events dominating the incorporation of vascular grafts was hitherto lacking. By focusing on the three main contemporary graft types, expanded polytetrafluoroethylene (ePTFE), Dacron and Polyurethane (PU), accumulated clinical and experimental experience of almost half a century was available. The main outcome of this broad analysis-supported by our own experience in a senescent non-human primate model-was twofold: Firstly, inappropriate animal models, which addressed scientific questions that missed the point of clinical relevance, were largely used. This led to a situation where the vast majority of investigators unintentionally studied transanastomotic rather than transmural or blood-borne endothelialization. Given the fact that in patients transanastomotic endothelialization (TAE) covers only the immediate perianastomotic region of sometimes very long prostheses, TAE is rather irrelevant in the clinical context. Secondly, transmural endothelialization seems to have a time window of opportunity before a build-up of an adverse microenvironment. In selecting animal models that prematurely terminate this build-up through the early presence of an endothelium, the most significant 'impairment factor' for physiological tissue regeneration in vascular grafts remained ignored. By providing insight into mechanisms and experimental designs which obscured the purpose and scope of several decades of vascular graft studies, future research may better address clinical relevance.
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Affiliation(s)
- Peter Zilla
- Christian Barnard Department of Cardiothoracic Surgery/Cardiovascular Research Unit, University of Cape Town Medical School, Cape Town, South Africa.
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Pavon-Djavid G, Gamble LJ, Ciobanu M, Gueguen V, Castner DG, Migonney V. Bioactive Poly(ethylene terephthalate) Fibers and Fabrics: Grafting, Chemical Characterization, and Biological Assessment. Biomacromolecules 2007; 8:3317-25. [DOI: 10.1021/bm070344i] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G. Pavon-Djavid
- Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS/B2OA−UMR 7052) Institut Galilée, Université Paris 13, 99 Avenue Jean-Baptiste Clément, 93430 Villetaneuse, France, and National Electron Spectroscopy for Chemical Analysis and Surface Analysis Center for Biomedical Problems, Departments of Bioengineering and Chemical Engineering, Box 351750, University of Washington, Seattle, Washington 98195-1750
| | - L. J. Gamble
- Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS/B2OA−UMR 7052) Institut Galilée, Université Paris 13, 99 Avenue Jean-Baptiste Clément, 93430 Villetaneuse, France, and National Electron Spectroscopy for Chemical Analysis and Surface Analysis Center for Biomedical Problems, Departments of Bioengineering and Chemical Engineering, Box 351750, University of Washington, Seattle, Washington 98195-1750
| | - M. Ciobanu
- Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS/B2OA−UMR 7052) Institut Galilée, Université Paris 13, 99 Avenue Jean-Baptiste Clément, 93430 Villetaneuse, France, and National Electron Spectroscopy for Chemical Analysis and Surface Analysis Center for Biomedical Problems, Departments of Bioengineering and Chemical Engineering, Box 351750, University of Washington, Seattle, Washington 98195-1750
| | - V. Gueguen
- Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS/B2OA−UMR 7052) Institut Galilée, Université Paris 13, 99 Avenue Jean-Baptiste Clément, 93430 Villetaneuse, France, and National Electron Spectroscopy for Chemical Analysis and Surface Analysis Center for Biomedical Problems, Departments of Bioengineering and Chemical Engineering, Box 351750, University of Washington, Seattle, Washington 98195-1750
| | - D. G. Castner
- Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS/B2OA−UMR 7052) Institut Galilée, Université Paris 13, 99 Avenue Jean-Baptiste Clément, 93430 Villetaneuse, France, and National Electron Spectroscopy for Chemical Analysis and Surface Analysis Center for Biomedical Problems, Departments of Bioengineering and Chemical Engineering, Box 351750, University of Washington, Seattle, Washington 98195-1750
| | - V. Migonney
- Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS/B2OA−UMR 7052) Institut Galilée, Université Paris 13, 99 Avenue Jean-Baptiste Clément, 93430 Villetaneuse, France, and National Electron Spectroscopy for Chemical Analysis and Surface Analysis Center for Biomedical Problems, Departments of Bioengineering and Chemical Engineering, Box 351750, University of Washington, Seattle, Washington 98195-1750
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Ishii Y, Kronengold RT, Virmani R, Rivera EA, Goldman SM, Prechtel EJ, Schuessler RB, Damiano RJ. Novel Bioengineered Small Caliber Vascular Graft With Excellent One-Month Patency. Ann Thorac Surg 2007; 83:517-25. [PMID: 17257981 DOI: 10.1016/j.athoracsur.2006.09.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2005] [Revised: 09/06/2006] [Accepted: 09/07/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND A bioengineered microporous polycarbonate-siloxane polyurethane graft has been developed for coronary artery bypass grafting. Biological agents can be impregnated into its absorbable collagen and hyaluronan microstructure and stable macrostructure to promote patency. The objective of this study was to examine the biological performance and biomechanical characteristics of this graft. METHODS Heparin-sirolimus (HS) or heparin-sirolimus-vascular endothelial growth factor (HSV) grafts were manufactured for this study. Heparin (40 U) was embedded in the microstructure of the graft for early elution from the graft wall. Heparin (100 U) and sirolimus (450 microg) were incorporated into the macrostructure of the graft for late elution. Vascular endothelial growth factor was also embedded in the microstructure of the graft. Both grafts (3.6 mm internal diameter, 24 mm length) were implanted into the abdominal aortas of rabbits (n = 36) to compare with heparin-alone (H) grafts (n = 9). At 4 hours, 1 day, and 1, 2, and 4 weeks after surgery, the grafts were removed for histologic, immunohistochemical, and biomechanical evaluations. RESULTS The patency rate of all grafts was 100% at each time point. None of grafts had stenosis after surgery. Endothelial cells were observed at 4 weeks after surgery in the HS, HSV, and H grafts. Although there was no significant difference of neointima thickness among the HS, HSV, and H grafts (136 +/- 75, 93 +/- 64, and 125 +/- 90 microm; p = 0.08), the H grafts did have more cellular infiltration in the graft than the HS or HSV grafts. There was neocapillary formation inside the graft wall at 4 weeks in all grafts. The graft macrostructure was unchanged based on biomechanical evaluation 4 weeks after surgery. CONCLUSIONS A unique drug-eluting graft had excellent patency at 1 month and may encourage luminal endothelialization without excessive intimal hyperplasia. Although vascular endothelial growth factor did not improve intimal formation, cell infiltration, or vascularization, sirolimus might inhibit cell proliferation. Further long-term study would need to evaluate the efficacy of impregnated sirolimus.
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Affiliation(s)
- Yosuke Ishii
- Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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Deepa P, Jayakannan M. Microporous polyurethanes: Synthesis and investigation of the mechanism of the pore formation. ACTA ACUST UNITED AC 2006. [DOI: 10.1002/polb.20786] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kannan RY, Salacinski HJ, Odlyha M, Butler PE, Seifalian AM. The degradative resistance of polyhedral oligomeric silsesquioxane nanocore integrated polyurethanes: An in vitro study. Biomaterials 2006; 27:1971-9. [PMID: 16253324 DOI: 10.1016/j.biomaterials.2005.10.006] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2005] [Accepted: 10/03/2005] [Indexed: 12/29/2022]
Abstract
Polymer biostability is one of the critical parameters by which these materials are selected for use as biomedical devices. This is the major rationale for the use of polymers which are highly crystalline and stiff namely expanded polytetrafluoroethylene (ePTFE) and Dacron in particular, as arterial bypass grafts. While this is immaterial in high-flow states, it becomes critically important at lower flows with a greater need for more compliant vessels. Polyurethanes being one of the most compliant polymers known are as such, the natural choice to build such constructs. However, concerns regarding their resistance to degradation have limited their use as vascular prostheses and in order to augment their strength, herein a novel polyhedral oligomeric silsesquioxane integrated poly(carbonate-urea)urethane (POSS-PCU) nanocomposite was synthesised by our group. In the following series of experiments, the POSS-PCU nanocomposite samples were exposed to accelerated degradative solutions, in an 'in-house' established model in vitro for up to 70 days before being subjected to infra-red spectroscopy, scanning electron microscopy, stress-strain studies and differential scanning calorimetry. Our results demonstrate that these silsesquioxane nanocores shield the soft segment(s) of the polyurethane, responsible for its compliance and elasticity from all forms of degradation, principally oxidation and hydrolysis. These nanocomposites hence provide an optimal method by which these polymers may be strengthened whilst maintaining their elasticity, making them ideal as vascular prostheses particularly at low flow states.
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Affiliation(s)
- Ruben Y Kannan
- Biomaterials & Tissue Engineering Centre (BTEC), Academic Division of Surgical and Interventional Sciences, University College London, Rowland Hill, Hampstead, London NW3 2PF, UK
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Neves-Junior WFP, Graeff CFDO, Ferreira M, Mulato M, Bernardes MS, Coutinho-Netto J. Elastic properties of natural rubber tubes produced by dip-coating. J Appl Polym Sci 2006. [DOI: 10.1002/app.23416] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kannan RY, Salacinski HJ, Butler PE, Hamilton G, Seifalian AM. Current status of prosthetic bypass grafts: A review. J Biomed Mater Res B Appl Biomater 2005; 74:570-81. [PMID: 15889440 DOI: 10.1002/jbm.b.30247] [Citation(s) in RCA: 334] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Polymers such as Dacron and polytetrafluoroethylene (PTFE) have been used in high flow states with relative success but with limited application at lower flow states. Newer polymers with greater compliance, biomimicry, and ability to evolve into hybrid prostheses, suitable as smaller vessels, are now being introduced. In view of the advances in tissue engineering, this makes possible the creation of an ideal off-the-shelf bypass graft. We present a broad overview of the current state of prosthetic bypass grafts.
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Affiliation(s)
- Ruben Y Kannan
- Biomaterials & Tissue Engineering Centre, University Department of Surgery, Royal Free and University College Medical School, University College London, UK
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Rashid ST, Salacinski HJ, Fuller BJ, Hamilton G, Seifalian AM. Engineering of bypass conduits to improve patency. Cell Prolif 2004; 37:351-66. [PMID: 15377334 PMCID: PMC6495671 DOI: 10.1111/j.1365-2184.2004.00318.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
For patients with severe coronary artery and distal peripheral vascular disease not amenable to angioplasty and lacking sufficient autologous vessels there is a pressing need for improvements to current surgical bypass options. It has been decades since any real progress in bypass material has reached mainstream surgical practice. This review looks at possible remedies to this situation. Options considered are methods to reduce prosthetic graft thrombogenicity, including endothelial cell seeding and developments of new prosthetic materials. The promise of tissue-engineered blood vessels is examined with a specific look at how peptides can improve cell adhesion to scaffolds.
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Affiliation(s)
- S T Rashid
- Biomaterials and Tissue Engineering Centre, University Department of Surgery, Royal Free and University College Medical School, University College London, Royal Free Hospital, London, UK
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Nowatzki PJ, Tirrell DA. Physical properties of artificial extracellular matrix protein films prepared by isocyanate crosslinking. Biomaterials 2004; 25:1261-7. [PMID: 14643600 DOI: 10.1016/s0142-9612(03)00635-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Artificial extracellular matrix proteins, genetically engineered from elastin- and fibronectin-derived repeating units, were crosslinked with hexamethylene diisocyanate in dimethylsulfoxide. The resulting hydrogel films were transparent, uniform, and highly extensible. Their tensile moduli depended on crosslinker concentration and spanned the range characteristic of native elastin. The water content of the films was low ( approximately 27%), but the temperature-dependent swelling behavior of the crosslinked materials was reminiscent of the lower critical solution temperature property of the soluble polymers.
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Affiliation(s)
- Paul J Nowatzki
- Division of Chemistry and Chemical Engineering, 210-41, California Institute of Technology, Pasadena, CA 91125, USA
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Machy D, Carteron P, Jozefonvicz J. A new vascular polyester prosthesis impregnated with cross-linked dextran. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2003; 13:963-75. [PMID: 12463514 DOI: 10.1163/156856202320401997] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
It is essential that a synthetic vascular graft is preclotting prior to implantation in order to prevent blood leaking through the graft wall. We have impregnated a knitted polyester prosthesis with cross-linked dextran. The aim of this study was to develop a process for obtaining an impervious prosthesis and to compare the characteristics of this dextran-impregnated graft with those of a commercially available collagen-impregnated graft. This new vascular prosthesis was coated with dextran; sodium trimetaphosphate was utilized as the cross-linking agent. In an attempt to determine the optimal conditions for impregnation, the dynamic viscosity of the dextran solution was measured during the cross-linking reaction. The results suggest that the dynamic viscosity is correlated with the concentrations of dextran, sodium hydroxide, and sodium trimetaphosphate. The effect of temperature on the dynamic viscosity was also investigated. The water permeability, the coating weight, and the structure of the dextran-impregnated graft were compared with those of a collagen-impregnated prosthesis. The water permeability of the vascular grafts was reduced by dextran impregnation, from 1010 ml/min per cm2 for the control to 0.04 ml/min per cm2 under standard testing conditions. The dextran coating is capable of rendering the graft impervious to water. The coating weight of the graft treated with dextran was approximately the same as the weight of the collagen-impregnated graft. Finally, the morphology of the prosthetic wall was analyzed using scanning electron microscopy. The promotion of endothelial cell recovery was only observed for the polyester grafts treated with dextran or collagen.
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Affiliation(s)
- Delphine Machy
- Laboratoire de Recherches sur les Macromolécules, FRE 2314 CNRS, Université Paris 13, Avenue J.-B. Clément, 93430 Villetaneuse, France.
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Salacinski HJ, Tai NR, Carson RJ, Edwards A, Hamilton G, Seifalian AM. In vitro stability of a novel compliant poly(carbonate-urea)urethane to oxidative and hydrolytic stress. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2002; 59:207-18. [PMID: 11745555 DOI: 10.1002/jbm.1234] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Poly(ester)urethane and poly(ether)urethane vascular grafts fail in vivo because of hydrolytic and oxidative degradative mechanisms. Studies have shown that poly(carbonate)urethanes have enhanced resistance. There is still a need for a viable, nonrigid, small-diameter, synthetic vascular graft. In this study, we sought to confirm this by exposing a novel formulation of compliant poly(carbonate-urea)urethane (CPU) manufactured by an innovative process, resulting in a stress-free. Small-diameter prosthesis, and a conventional poly(ether)urethane Pulse-Tec graft known to readily undergo oxidation in a variety of degradative solutions, and we assessed them for the development of oxidative and hydrolytic degradation, changes in elastic properties, and chemical stability. To simulate the in vivo environment, we used buffered solutions of phospholipase A(2) and cholesterol esterase; solutions of H(2)O(2)/CoCl(2), t-butyl peroxide/CoCl(2) (t-but/CoCl(2)), and glutathione/t-butyl peroxide/CoCl(2) (Glut/t-but/CoCl(2)); and plasma fractions I-IV, which were derived from fresh human plasma centrifuged in poly(ethylene glycol). To act as a negative control, both graft types were incubated in distilled water. Samples of both graft types (100 mm with a 5.0-mm inner diameter) were incubated in these solutions at 37 degrees C for 70 days before environmental scanning electron microscopy, radial tensile strength and quality control, gel permeation chromatography, and in vitro compliance assessments were performed. Oxidative degradation was ascertained from significant changes in molecular weight with respect to a control on all Pulse-Tec grafts treated with t-but/CoCl(2), Glut/t-but/CoCl(2), and plasma fractions I-III. Pulse-Tec grafts exposed to the H(2)O(2)/CoCl(2) mixture had significantly greater compliance than controls incubated in distilled water (p < 0.001 at 50 mmHg). No changes in molecular weight with respect to the control were observed for the CPU samples; only those immersed in t-but/CoCl(2) and Glut/t-but/CoCl(2) showed an 11% increase in molecular weight to 108,000. Only CPU grafts treated with the Glut/t-but/CoCl(2) mixture exhibited significantly greater compliance (p < 0.05 at 50 mmHg). Overall, results from this study indicate that CPU presents a far greater chemical stability than poly(ether)-urethane grafts do.
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Affiliation(s)
- Henryk J Salacinski
- Tissue Engineering Laboratories, University Department of Surgery, Royal Free and University College Medical School, University College London, Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom
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