Manufacture and property research of heparin grafted electrospinning PCU artificial vascular scaffolds

Mapping the blueprint of artificial blood vessels research: a bibliometric analysis

BACKGROUND

Vascular diseases represent a significant cause of disability and death worldwide. The demand for artificial blood vessels is increasing due to the scarce supply of healthy autologous vessels. Nevertheless, the literature in this area remains sparse and inconclusive.

METHODS

Bibliometrics is the study of quantitative analysis of publications and their patterns. This study conducts a bibliometric analysis of publications on artificial blood vessels in the 21st century, examining performance distribution, research trajectories, the evolution of research hotspots, and the exploration of the knowledge base. This approach provides comprehensive insights into the knowledge structure of the field.

RESULTS

The search retrieved 2060 articles, showing a consistent rise in the publication volume and average annual citation frequency related to artificial blood vessels research. The United States is at the forefront of high-quality publications and international collaborations. Among academic institutions, Yale University is a leading contributor. The dominant disciplines within the artificial blood vessels sector include engineering, biomedical sciences, materials science, biomaterials science, and surgery, with surgery experiencing the most rapid expansion.

CONCLUSIONS

This study is the inaugural effort to bibliometrically analyze and visualize the scholarly output in the domain of artificial blood vessels. It provides clinicians and researchers with a reliable synopsis of the field's current state, offering a reference point for existing research and suggesting new avenues for future investigations.

Recent Advances in Polyurethane for Artificial Vascular Application

Artificial blood vessels made from polyurethane (PU) have been researched for many years but are not yet in clinical use. The main reason was that the PU materials are prone to degradation after contact with blood and will also cause inflammation after long-term implantation. At present, PU has made progress in biostability and biocompatibility, respectively. The PU for artificial blood vessels still requires a balance between material stability and biocompatibility to maintain its long-term stability in vivo, which needs to be further optimized. Based on the requirement of PU materials for artificial vascular applications, this paper views the development of biostable PU, bioactive PU, and bioresorbable PU. The improvement of biostable PU from the monomer structure, chemical composition, and additives are discussed to improve the long-term biostability in vivo. The surface grafting and functionalization methods of bioactive PU to reduce thrombosis and promote endothelialization for improving biocompatibility are summarized. In addition, the bioresorbable PU for tissue-engineered artificial blood vessels is discussed to balance between the degradation rate and mechanical properties. The ideal PU materials for artificial blood vessels must have good mechanical properties, stability, and biocompatibility at the same time. Finally, the application potential of PU materials in artificial vascular is prospected.

Improving hemocompatibility in tissue-engineered products employing heparin-loaded nanoplatforms

The enhancement of hemocompatibility through the use of nanoplatforms loaded with heparin represents a highly desirable characteristic in the context of emerging tissue engineering applications. The significance of employing heparin in biological processes is unquestionable, owing to its ability to interact with a diverse range of proteins. It plays a crucial role in numerous biological processes by engaging in interactions with diverse proteins and hydrogels. This review provides a summary of recent endeavors focused on augmenting the hemocompatibility of tissue engineering methods through the utilization of nanoplatforms loaded with heparin. This study also provides a comprehensive review of the various applications of heparin-loaded nanofibers and nanoparticles, as well as the techniques employed for encapsulating heparin within these nanoplatforms. The biological and physical effects resulting from the encapsulation of heparin in nanoplatforms are examined. The potential applications of heparin-based materials in tissue engineering are also discussed, along with future perspectives in this field.

Coaxial 3D Bioprinting Process Research and Performance Tests on Vascular Scaffolds

Three-dimensionally printed vascularized tissue, which is suitable for treating human cardiovascular diseases, should possess excellent biocompatibility, mechanical performance, and the structure of complex vascular networks. In this paper, we propose a method for fabricating vascularized tissue based on coaxial 3D bioprinting technology combined with the mold method. Sodium alginate (SA) solution was chosen as the bioink material, while the cross-linking agent was a calcium chloride (CaCl2) solution. To obtain the optimal parameters for the fabrication of vascular scaffolds, we first formulated theoretical models of a coaxial jet and a vascular network. Subsequently, we conducted a simulation analysis to obtain preliminary process parameters. Based on the aforementioned research, experiments of vascular scaffold fabrication based on the coaxial jet model and experiments of vascular network fabrication were carried out. Finally, we optimized various parameters, such as the flow rate of internal and external solutions, bioink concentration, and cross-linking agent concentration. The performance tests showed that the fabricated vascular scaffolds had levels of satisfactory degradability, water absorption, and mechanical properties that meet the requirements for practical applications. Cellular experiments with stained samples demonstrated satisfactory proliferation of human umbilical vein endothelial cells (HUVECs) within the vascular scaffold over a seven-day period, observed under a fluorescent inverted microscope. The cells showed good biocompatibility with the vascular scaffold. The above results indicate that the fabricated vascular structure initially meet the requirements of vascular scaffolds.

Electrospun Poly(carbonate-urea-urethane)s Nonwovens with Shape-Memory Properties as a Potential Biomaterial

Poly(carbonate-urea-urethane) (PCUU)-based scaffolds exhibit various desirable properties for tissue engineering applications. This study thus aimed to investigate the suitability of PCUU as polymers for the manufacturing of nonwoven mats by electrospinning, able to closely mimic the fibrous structure of the extracellular matrix. PCUU nonwovens of fiber diameters ranging from 0.28 ± 0.07 to 0.82 ± 0.12 μm were obtained with an average surface porosity of around 50-60%. Depending on the collector type and solution concentration, a broad range of tensile strengths (in the range of 0.3-9.6 MPa), elongation at break (90-290%), and Young's modulus (5.7-26.7 MPa) at room temperature of the nonwovens could be obtained. Furthermore, samples collected on the plate collector showed a shape-memory effect with a shape-recovery ratio (Rr) of around 99% and a shape-fixity ratio (Rf) of around 96%. Biological evaluation validated the inertness, stability, and lack of cytotoxicity of PCUU nonwovens obtained on the plate collector. The ability of mesenchymal stem cells (MSCs) and endothelial cells (HUVECs) to attach, elongate, and grow on the surface of the nonwovens suggests that the manufactured nonwovens are suitable scaffolds for tissue engineering applications.

Small-diameter PCL/PU vascular graft modified with heparin-aspirin compound for preventing the occurrence of acute thrombosis

The occurrence of acute thrombosis, directly related to platelet aggregation and coagulant system, is a considerable reason for the failure of small-diameter vascular grafts. Heparin is commonly used as a functional molecule for graft modification due to the strong anticoagulant effect. Unfortunately, heparin cannot directly resist the adhesion and aggregation of platelets. Therefore, we have prepared a heparin-aspirin compound by coupling heparin with aspirin, an antiplatelet drug, and covalently grafted it onto the surface of polycaprolactone/polyurethane composite tube. In this way, the graft not only showed a dual function of both anticoagulation and antiplatelet, but also effectively avoided the rapid drug release and excessive toxicity to other organs caused by simple blending the medicine with material matrix. The compound retained the original function of heparin, showing good hydrophilicity and biocompatibility, which could promote the adhesion and proliferation of endothelial cells (ECs) and facilitate the process of tissue regeneration. What's more, the compound showed more effective than heparin in reducing platelet activation and preventing thrombosis. The graft modified by this compound maintained completely unobstructed for one month of implantation, while severe obstruction or stenosis occurred in PCL/PU and PCL/PU-Hep lumen at the first week, verifying the effect of the compound on preventing acute thrombosis. In general, this study proposed a designing method for small-diameter vascular graft which could prevent acute thrombosis and promote intimal construction.

Resealable Antithrombotic Artificial Vascular Graft Integrated with a Self-Healing Blood Flow Sensor

Coronary artery bypass grafting is commonly used to treat cardiovascular diseases by replacing blocked blood vessels with autologous or artificial blood vessels. Nevertheless, the availability of autologous vessels in infants and the elderly and low long-term patency rate of grafts hinder extensive application of autologous vessels in clinical practice. The biological and mechanical properties of the resealable antithrombotic artificial vascular graft (RAAVG) fabricated herein, comprising a bioelectronic conduit based on a tough self-healing polymer (T-SHP) and a lubricious inner coating, match with the functions of autologous blood vessels. The self-healing and elastic properties of the T-SHP confer resistance against mechanical stimuli and promote conformal sealing of suturing regions, thereby preventing leakage (stable fixation under a strain of 50%). The inner layer of the RAAVG presents antibiofouling properties against blood cells and proteins, and antithrombotic properties, owing to its lubricious coating. Moreover, the blood-flow sensor fabricated using the T-SHP and carbon nanotubes is seamlessly integrated into the RAAVG via self-healing and allows highly sensitive monitoring of blood flow at low and high flow rates (10- and 100 mL min^-1, respectively). Biocompatibility and feasibility of RAAVG as an artificial graft were demonstrated via ex vivo, and in vivo experiment using a rodent model. The use of RAAVGs to replace blocked blood vessels can improve the long-term patency rate of coronary artery bypass grafts.

A critical review of fibrous polyurethane-based vascular tissue engineering scaffolds

Certain polymeric materials such as polyurethanes (PUs) are the most prevalent class of used biomaterials in regenerative medicine and have been widely explored as vascular substitutes in several animal models. It is thought that PU-based biomaterials possess suitable hemo-compatibility with comparable performance related to the normal blood vessels. Despite these advantages, the possibility of thrombus formation and restenosis limits their application as artificial functional vessels. In this regard, various surface modification approaches have been developed to enhance both hemo-compatibility and prolong patency. While critically reviewing the recent advances in vascular tissue engineering, mainly PU grafts, this paper summarizes the application of preferred cell sources to vascular regeneration, physicochemical properties, and some possible degradation mechanisms of PU to provide a more extensive perspective for future research.

Remodeling of Structurally Reinforced (TPU+PCL/PCL)-Hep Electro-spun Small Diameter Bilayer Vascular Grafts Interposed in Rat Ab-dominal Aorta

As the thermoplastic polyurethane (TPU) elastomer possesses good biocompatibility and mechanical properties similar to native vascular tissues as well, it is intended to co-electrospin with poly(ε-caprolactone) (PCL) onto the outer...

Research progress, models and simulation of electrospinning technology: a review

In recent years, nanomaterials have aroused extensive research interest in the world's material science community. Electrospinning has the advantages of wide range of available raw materials, simple process, small fiber diameter and high porosity. Electrospinning as a nanomaterial preparation technology with obvious advantages has been studied, such as its influencing parameters, physical models and computer simulation. In this review, the influencing parameters, simulation and models of electrospinning technology are summarized. In addition, the progresses in applications of the technology in biomedicine, energy and catalysis are reported. This technology has many applications in many fields, such as electrospun polymers in various aspects of biomedical engineering. The latest achievements in recent years are summarized, and the existing problems and development trends are analyzed and discussed.

Electrospun nanofiber scaffold for vascular tissue engineering

Due to the prevalence of cardiovascular diseases, there is a large need for small diameter vascular grafts that cannot be fulfilled using autologous vessels. Although medium to large diameter synthetic vessels are in use, no suitable small diameter vascular graft has been developed due to the unique dynamic environment that exists in small vessels. To achieve long term patency, a successful tissue engineered vascular graft would need to closely match the mechanical properties of native tissue, be non-thrombotic and non-immunogenic, and elicit the proper healing response and undergo remodeling to incorporate into the native vasculature. Electrospinning presents a promising approach to the development of a suitable tissue engineered vascular graft. This review provides a comprehensive overview of the different polymers, techniques, and functionalization approaches that have been used to develop an electrospun tissue engineered vascular graft.

A biomimetic orthogonal-bilayer tubular scaffold for the co-culture of endothelial cells and smooth muscle cells

In blood vessels, endothelial cells (ECs) grow along the direction of blood flow, while smooth muscle cells (SMCs) grow circumferentially along the vessel wall. To mimic this structure, a polycaprolactone (PCL) tubular scaffold with orthogonally oriented bilayer nanofibers was prepared via electrospinning and winding. ECs were cultured on the inner layer of the scaffold with axial nanofibers and SMCs were cultured on the outer layer of the scaffold with circumferential nanofibers. Fluorescence images of the F-actin distribution of ECs and SMCs indicated that cells adhered, stretched, and proliferated in an oriented manner on the scaffold. Moreover, layers of ECs and SMCs formed on the scaffold after one month of incubation. The expression levels of platelet-endothelial cell adhesion molecule 1 (PECAM-1) and a contractile SMC phenotype marker in the EC/SMC co-culture system were much higher than those in individual culture systems, thus demonstrating that the proposed biomimetic scaffold promoted the intercellular junction of ECs and preserved the contractile phenotype of SMCs.

To mimic blood vessels, a polycaprolactone tubular scaffold was prepared via electrospinning and winding. Endothelial cells were cultured on the inner layer with axial nanofibers and smooth muscle cells were cultured on the outer layer with circumferential nanofibers.

Blood biocompatibility enhancement of biomaterials by heparin immobilization: a review

Blood contacting materials are concerned with biocompatibility including thrombus formation, decrease blood coagulation time, hematology, activation of complement system, platelet aggression. Interestingly, recent research suggests that biocompatibility is increasing by incorporating various materials including heparin using different methods. Basic of heparin including uses and complications was mentioned, in which burst release of heparin is major issue. To minimize the problem of biocompatibility and unpredictable heparin release, present review article potentially reviews the reported work and investigates the various immobilization methods of heparin onto biomaterials, such as polymers, metals, and alloys. Detailed explanation of different immobilization methods through different intermediates, activation, incubation method, plasma treatment, irradiations and other methods are also discussed, in which immobilization through intermediates is the most exploitable method. In addition to biocompatibility, other required properties of biomaterials like mechanical and corrosion resistance properties that increase by attachment of heparin are reviewed and discussed in this article.

Glycosaminoglycans: From Vascular Physiology to Tissue Engineering Applications

Cardiovascular diseases represent the number one cause of death globally, with atherosclerosis a major contributor. Despite the clinical need for functional arterial substitutes, success has been limited to arterial replacements of large-caliber vessels (diameter > 6 mm), leaving the bulk of demand unmet. In this respect, one of the most challenging goals in tissue engineering is to design a "bioactive" resorbable scaffold, analogous to the natural extracellular matrix (ECM), able to guide the process of vascular tissue regeneration. Besides adequate mechanical properties to sustain the hemodynamic flow forces, scaffold's properties should include biocompatibility, controlled biodegradability with non-toxic products, low inflammatory/thrombotic potential, porosity, and a specific combination of molecular signals allowing vascular cells to attach, proliferate and synthesize their own ECM. Different fabrication methods, such as phase separation, self-assembly and electrospinning are currently used to obtain nanofibrous scaffolds with a well-organized architecture and mechanical properties suitable for vascular tissue regeneration. However, several studies have shown that naked scaffolds, although fabricated with biocompatible polymers, represent a poor substrate to be populated by vascular cells. In this respect, surface functionalization with bioactive natural molecules, such as collagen, elastin, fibrinogen, silk fibroin, alginate, chitosan, dextran, glycosaminoglycans (GAGs), and growth factors has proven to be effective. GAGs are complex anionic unbranched heteropolysaccharides that represent major structural and functional ECM components of connective tissues. GAGs are very heterogeneous in terms of type of repeating disaccharide unit, relative molecular mass, charge density, degree and pattern of sulfation, degree of epimerization and physicochemical properties. These molecules participate in a number of vascular events such as the regulation of vascular permeability, lipid metabolism, hemostasis, and thrombosis, but also interact with vascular cells, growth factors, and cytokines to modulate cell adhesion, migration, and proliferation. The primary goal of this review is to perform a critical analysis of the last twenty-years of literature in which GAGs have been used as molecular cues, able to guide the processes leading to correct endothelialization and neo-artery formation, as well as to provide readers with an overall picture of their potential as functional molecules for small-diameter vascular regeneration.

Acellular Small-Diameter Tissue-Engineered Vascular Grafts

Tissue-engineered vascular grafts (TEVGs) are considered one of the most effective means of fabricating vascular grafts. However, for small-diameter TEVGs, there are ongoing issues regarding long-term patency and limitations related to long-term in vitro culture and immune reactions. The use of acellular TEVG is a more convincing method, which can achieve in situ blood vessel regeneration and better meet clinical needs. This review focuses on the current state of acellular TEVGs based on scaffolds and gives a summary of the methodologies and in vitro/in vivo test results related to acellular TEVGs obtained in recent years. Various strategies for improving the properties of acellular TEVGs are also discussed.

State of the Art of Small-Diameter Vessel-Polyurethane Substitutes

Cardiovascular diseases are a severe threat to human health. Implantation of small-diameter vascular substitutes is a promising therapy in clinical operations. Polyurethane (PU) is considered one of the most suitable materials for this substitution due to its good mechanical properties, controlled biostability, and proper biocompatibility. According to biodegradability and biostability, in this review, PU small-diameter vascular substitutes are divided into two groups: biodegradable scaffolds and biostable prostheses, which are applied to the body for short- and long-term, respectively. Following this category, the degradation principles and mechanisms of different kinds of PUs are first discussed; then the chemical and physical methods for adjusting the properties and the research advances are summarized. On the basis of these discussions, the problems remaining at present are addressed, and the contour of future research and development of PU-based small-diameter vascular substitutes toward clinical applications is outlined.

Experimental and analytical evaluation on the mass transfer performance of braided stent-grafts

Endoleak and luminal loss related to blood permeation and microthrombus migration remain the main challenges in the aneurysm treatment, although stent-grafts have been widely applied. Stent-grafts provide a boundary to shield blood and microemboli transport, which are correlated with their mass transfer performance. Water permeability of vascular prostheses with woven and knitted structures has been analyzed and documented by many researchers, as well as oxygen and protein transfer. However, it is almost a total lack of blood and microemboli transfer along the braided stent-graft thickness direction. In this research, we provided a methodology for the vascular prostheses mass transfer evaluation. Braided stent-grafts in our former research were conducted on a self-developed testing system to investigate their blood permeability and microthrombus transfer behaviors. The pressure along wall thickness direction can be changed. Analytical models were also established based on pore parameters, making them applicative to different structures. Results revealed that the mass transfer behavior of stent-grafts was positively affected by porosity and pore diameter while negatively influenced by their thickness.