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Asciak L, Domingo-Roca R, Dow JR, Brodie R, Paterson N, Riches PE, Shu W, McCormick C. Exploiting light-based 3D-printing for the fabrication of mechanically enhanced, patient-specific aortic grafts. J Mech Behav Biomed Mater 2024; 154:106531. [PMID: 38588633 DOI: 10.1016/j.jmbbm.2024.106531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/10/2024]
Abstract
Despite polyester vascular grafts being routinely used in life-saving aortic aneurysm surgeries, they are less compliant than the healthy, native human aorta. This mismatch in mechanical behaviour has been associated with disruption of haemodynamics contributing to several long-term cardiovascular complications. Moreover, current fabrication approaches mean that opportunities to personalise grafts to the individual anatomical features are limited. Various modifications to graft design have been investigated to overcome such limitations; yet optimal graft functionality remains to be achieved. This study reports on the development and characterisation of an alternative vascular graft material. An alginate:PEGDA (AL:PE) interpenetrating polymer network (IPN) hydrogel has been produced with uniaxial tensile tests revealing similar strength and stiffness (0.39 ± 0.05 MPa and 1.61 ± 0.19 MPa, respectively) to the human aorta. Moreover, AL:PE tubular conduits of similar geometrical dimensions to segments of the aorta were produced, either via conventional moulding methods or stereolithography (SLA) 3D-printing. While both fabrication methods successfully demonstrated AL:PE hydrogel production, SLA 3D-printing was more easily adaptable to the fabrication of complex structures without the need of specific moulds or further post-processing. Additionally, most 3D-printed AL:PE hydrogel tubular conduits sustained, without failure, compression up to 50% their outer diameter and returned to their original shape upon load removal, thereby exhibiting promising behaviour that could withstand pulsatile pressure in vivo. Overall, these results suggest that this AL:PE IPN hydrogel formulation in combination with 3D-printing, has great potential for accelerating progress towards personalised and mechanically-matched aortic grafts.
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Affiliation(s)
- Lisa Asciak
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Roger Domingo-Roca
- Department of Electronic and Electric Engineering, University of Strathclyde, Glasgow, UK
| | - Jamie R Dow
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK; Research and Development, Terumo Aortic Ltd., Inchinnan, Glasgow, UK
| | - Robbie Brodie
- Research and Development, Terumo Aortic Ltd., Inchinnan, Glasgow, UK
| | - Niall Paterson
- Research and Development, Terumo Aortic Ltd., Inchinnan, Glasgow, UK
| | - Philip E Riches
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Wenmiao Shu
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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Bartolf-Kopp M, Jungst T. The Past, Present, and Future of Tubular Melt Electrowritten Constructs to Mimic Small Diameter Blood Vessels - A Stable Process? Adv Healthc Mater 2024:e2400426. [PMID: 38607966 DOI: 10.1002/adhm.202400426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/20/2024] [Indexed: 04/14/2024]
Abstract
Melt Electrowriting (MEW) is a continuously growing manufacturing platform. Its advantage is the consistent production of micro- to nanometer fibers, that stack intricately, forming complex geometrical shapes. MEW allows tuning of the mechanical properties of constructs via the geometry of deposited fibers. Due to this, MEW can create complex mechanics only seen in multi-material compounds and serve as guiding structures for cellular alignment. The advantage of MEW is also shown in combination with other biotechnological manufacturing methods to create multilayered constructs that increase mechanical approximation to native tissues, biocompatibility, and cellular response. These features make MEW constructs a perfect candidate for small-diameter vascular graft structures. Recently, studies have presented fascinating results in this regard, but is this truly the direction that tubular MEW will follow or are there also other options on the horizon? This perspective will explore the origins and developments of tubular MEW and present its growing importance in the field of artificial small-diameter vascular grafts with mechanical modulation and improved biomimicry and the impact of it in convergence with other manufacturing methods and how future technologies like AI may influence its progress.
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Affiliation(s)
- Michael Bartolf-Kopp
- Department for Functional Materials in Medicine and Dentistry, Institute of Biofabrication and Functional Materials, University of Würzburg and KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI), Würzburg, Germany
| | - Tomasz Jungst
- Department for Functional Materials in Medicine and Dentistry, Institute of Biofabrication and Functional Materials, University of Würzburg and KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI), Würzburg, Germany
- Department of Orthopedics, Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands
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Behr JM, Wong YS, Venkatraman S. Small-Diameter Blood Vessel Substitutes: Biomimetic Approaches to Improve Patency. Biomimetics (Basel) 2024; 9:97. [PMID: 38392143 PMCID: PMC10886630 DOI: 10.3390/biomimetics9020097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 02/24/2024] Open
Abstract
Small-dimeter blood vessels (<6 mm) are required in coronary bypass and peripheral bypass surgery to circumvent blocked arteries. However, they have poor patency rates due to thrombus formation, intimal hyperplasia at the distal anastomosis, and compliance mismatch between the native artery and the graft. This review covers the state-of-the-art technologies for improving graft patency with a focus on reducing compliance mismatch between the prosthesis and the native artery. The focus of this article is on biomimetic design strategies to match the compliance over a wide pressure range.
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Affiliation(s)
- Jean-Marc Behr
- SMD Swiss Medical Devices AG, 8222 Beringen, Switzerland
| | - Yee Shan Wong
- Biomedical Engineering, School of Engineering, Temasek Polytechnic, Singapore 529757, Singapore
| | - Subbu Venkatraman
- Materials Science and Engineering, National University of Singapore, Singapore 117575, Singapore
- iHealthTech, National University of Singapore, Singapore 117599, Singapore
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Jiang X, Zeng YE, Li C, Wang K, Yu DG. Enhancing diabetic wound healing: advances in electrospun scaffolds from pathogenesis to therapeutic applications. Front Bioeng Biotechnol 2024; 12:1354286. [PMID: 38375451 PMCID: PMC10875055 DOI: 10.3389/fbioe.2024.1354286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
Diabetic wounds are a significant subset of chronic wounds characterized by elevated levels of inflammatory cytokines, matrix metalloproteinases (MMPs), and reactive oxygen species (ROS). They are also associated with impaired angiogenesis, persistent infection, and a high likelihood of hospitalization, leading to a substantial economic burden for patients. In severe cases, amputation or even mortality may occur. Diabetic foot ulcers (DFUs) are a common complication of diabetes, with up to 25% of diabetic patients being at risk of developing foot ulcers over their lifetime, and more than 70% ultimately requiring amputation. Electrospun scaffolds exhibit a structural similarity to the extracellular matrix (ECM), promoting the adhesion, growth, and migration of fibroblasts, thereby facilitating the formation of new skin tissue at the wound site. The composition and size of electrospun scaffolds can be easily adjusted, enabling controlled drug release through fiber structure modifications. The porous nature of these scaffolds facilitates gas exchange and the absorption of wound exudate. Furthermore, the fiber surface can be readily modified to impart specific functionalities, making electrospinning nanofiber scaffolds highly promising for the treatment of diabetic wounds. This article provides a concise overview of the healing process in normal wounds and the pathological mechanisms underlying diabetic wounds, including complications such as diabetic foot ulcers. It also explores the advantages of electrospinning nanofiber scaffolds in diabetic wound treatment. Additionally, it summarizes findings from various studies on the use of different types of nanofiber scaffolds for diabetic wounds and reviews methods of drug loading onto nanofiber scaffolds. These advancements broaden the horizon for effectively treating diabetic wounds.
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Affiliation(s)
- Xuewen Jiang
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai, China
| | - Yu-E Zeng
- Department of Neurology, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaofei Li
- Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ke Wang
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai, China
| | - Deng-Guang Yu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai, China
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Ryu S, Shim J. Development of Highly Hygienic Textile by Coating with Encapsulated Ginseng Oil. Polymers (Basel) 2023; 15:4352. [PMID: 38006078 PMCID: PMC10674727 DOI: 10.3390/polym15224352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
There is a growing demand for the development of functional textile sanitary products to protect the human body from viruses, bacteria, and other harmful external substances. However, common processing methods for textile functionalization result in poor durability or have a highly limited material scope. A solution for this is the encapsulation of the functional material to provide stable protection and controlled release to reveal functionality in the fabric. However, many chemicals used for such purposes can cause problems for both human beings and the environment; therefore, attention is being shifted to natural products such as essential oils and seed oils. In this study, we used in situ polymerization to encapsulate ginseng oil, which has antibacterial, deodorizing, moisturizing, and antioxidant functions, as the core material of the microcapsules. The manufactured microcapsules were spherical with smooth surfaces, had an average size of 3.98 um, and exhibited excellent thermal stability. Processing the synthesized microcapsules into nylon/polyurethane fabric resulted in excellent functionalities, with the treated fabric exhibiting a 99.9% antibacterial activity against Staphylococcus aureus and Klebsiella pneumoniae and a 99% deodorizing effect. Therefore, the developed method is expected to show great potential for the production of highly hygienic textiles for use in various industries.
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Affiliation(s)
- Sujin Ryu
- Advanced Textile R&D Department, Research Institute of Convergence Technology, Korea Institute of Industrial Technology (KITECH), 143 Hanggaulro, Sangnok-gu, Ansan-si 15588, Gyeonggi-do, Republic of Korea
| | - Jaeyun Shim
- Advanced Textile R&D Department, Research Institute of Convergence Technology, Korea Institute of Industrial Technology (KITECH), 143 Hanggaulro, Sangnok-gu, Ansan-si 15588, Gyeonggi-do, Republic of Korea
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Charchyan ER, Breshenkov DG, Belov YV. The Frozen Elephant Trunk Procedure Using New Russian Hybrid Prosthesis "Soft Elephant Trunk": the Early Experience. KARDIOLOGIIA 2023; 63:29-37. [PMID: 37815137 DOI: 10.18087/cardio.2023.9.n2109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/29/2022] [Indexed: 10/11/2023]
Abstract
Aim To present the first experience of performing the Frozen Elephant Trunk (FET) surgery in patients with thoracic aorta disease using a new Russian hybrid stent graft "Soft Elephant Trunk".Material and methods Between 2014 and 2021, 170 patients with thoracic aortic disease underwent complete aortic arch replacement using the FET technique. In 70 of these cases (since June 2019), a hybrid graft "Soft Elephant Trunk" was used. A specific feature of this graft is the conical reduction of the radial force of nitinol crowns and the soft distal end without radial force. The study endpoints were early postoperative results, as well as the absence of reoperations on the aorta, absence of stent-graft-associated complications, including distal stent-graft-induced fenestration, and survival at a mid-term follow-up of up to 2.5 years.Results Interventions were performed in patients with A type aortic dissection (n=51; 72.9 %), type B aortic dissection (n=13; 18.6 %), and thoracoabdominal aortic aneurysm (TAAA) (n=6; 8.5 %). In 14 (20 %) of these cases, interventions were performed after a primary intervention on the proximal aorta. Acute aortic dissection was diagnosed in 17 (24.3 %) cases. Aortic root replacement was performed in 21 (30 %) cases, David procedure in 5 (7.2 %) cases, Bentall-DeBono procedure in 11 (15.7 %) cases, and supracoronary graft placement in 33 (47.1 %) cases. There were no cases of paraplegia or paraparesis. Respiratory insufficiency was observed in 8 (11.4%) cases. In one (1.4%) case, acute renal failure developed, which required renal replacement therapy. In-hospital mortality was 4.3 % (3 patients died). Mean follow-up duration was 9 [4.25; 16] months. Three-year survival was 94 % (95 % confidence interval, CI: 88-99.9) and absence of reoperation was 96.6 % (95 % CI: 90.1-100). There were no cases of distal stent-graft-induced fenestration in this group.Conclusion The new hybrid graft, due to its specific structure, provides prevention of distal stent-graft-induced fenestration and, thereby, a stable long-term result. Using this stent-graft is effective in patients with thoracic aorta pathology undergoing the FET surgery. However, further studies are needed to determine potential advantages and disadvantages of this new hybrid graft, to obtain long-term results and accumulate experience.
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Affiliation(s)
- E R Charchyan
- Petrovsky Russian Scientific Center for Surgery, Moscow
| | | | - Yu V Belov
- Petrovsky Russian Scientific Center for Surgery, Moscow
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Liu C, Dai J, Wang X, Hu X. The Influence of Textile Structure Characteristics on the Performance of Artificial Blood Vessels. Polymers (Basel) 2023; 15:3003. [PMID: 37514393 PMCID: PMC10385882 DOI: 10.3390/polym15143003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Cardiovascular disease is a major threat to human health worldwide, and vascular transplantation surgery is a treatment method for this disease. Often, autologous blood vessels cannot meet the needs of surgery. However, allogeneic blood vessels have limited availability or may cause rejection reactions. Therefore, the development of biocompatible artificial blood vessels is needed to solve the problem of donor shortage. Tubular fabrics prepared by textile structures have flexible compliance, which cannot be matched by other structural blood vessels. Therefore, biomedical artificial blood vessels have been widely studied in recent decades up to the present. This article focuses on reviewing four textile methods used, at present, in the manufacture of artificial blood vessels: knitting, weaving, braiding, and electrospinning. The article mainly introduces the particular effects of different structural characteristics possessed by various textile methods on the production of artificial blood vessels, such as compliance, mechanical properties, and pore size. It was concluded that woven blood vessels possess superior mechanical properties and dimensional stability, while the knitted fabrication method facilitates excellent compliance, elasticity, and porosity of blood vessels. Additionally, the study prominently showcases the ease of rebound and compression of braided tubes, as well as the significant biological benefits of electrospinning. Moreover, moderate porosity and good mechanical strength can be achieved by changing the original structural parameters; increasing the floating warp, enlarging the braiding angle, and reducing the fiber fineness and diameter can achieve greater compliance. Furthermore, physical, chemical, or biological methods can be used to further improve the biocompatibility, antibacterial, anti-inflammatory, and endothelialization of blood vessels, thereby improving their functionality. The aim is to provide some guidance for the further development of artificial blood vessels.
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Affiliation(s)
- Chenxi Liu
- College of Textiles & Clothing, Qingdao University, Qingdao 266000, China
| | - Jieyu Dai
- College of Textiles & Clothing, Qingdao University, Qingdao 266000, China
| | - Xueqin Wang
- College of Textiles & Clothing, Qingdao University, Qingdao 266000, China
| | - Xingyou Hu
- College of Textiles & Clothing, Qingdao University, Qingdao 266000, China
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8
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Rovas G, Bikia V, Stergiopulos N. Design and computational optimization of compliance-matching aortic grafts. Front Bioeng Biotechnol 2023; 11:1179174. [PMID: 37456727 PMCID: PMC10341153 DOI: 10.3389/fbioe.2023.1179174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction: Synthetic vascular grafts have been widely used in clinical practice for aortic replacement surgery. Despite their high rates of surgical success, they remain significantly less compliant than the native aorta, resulting in a phenomenon called compliance mismatch. This incompatibility of elastic properties may cause serious post-operative complications, including hypertension and myocardial hypertrophy. Methods: To mitigate the risk for these complications, we designed a multi-layer compliance-matching stent-graft, that we optimized computationally using finite element analysis, and subsequently evaluated in vitro. Results: We found that our compliance-matching grafts attained the distensibility of healthy human aortas, including those of young adults, thereby significantly exceeding the distensibility of gold-standard grafts. The compliant grafts maintained their properties in a wide range of conditions that are expected after the implantation. Furthermore, the computational model predicted the graft radius with enough accuracy to allow computational optimization to be performed effectively. Conclusion: Compliance-matching grafts may offer a valuable improvement over existing prostheses and they could potentially mitigate the risk for post-operative complications attributed to excessive graft stiffness.
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Netsanet A, Cotton J, Suarez-Pierre A, Hoffman J, Aftab M, Reece B, Rove JY. Cardiac Surgeons Highlight the Need for Innovation Stewardship: Noteworthy in 2022. Semin Cardiothorac Vasc Anesth 2023; 27:136-144. [PMID: 37098029 DOI: 10.1177/10892532231173090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Modern cardiac surgery has rapidly evolved to treat complex cardiovascular disease. This past year boasted noteworthy advances in xenotransplantation, prosthetic cardiac valves, and endovascular thoracic aortic repair. Newer devices often offer incremental design changes while demanding significant cost increases that leave surgeons to decide if the benefit to patients justifies the increased cost. As innovations are introduced, surgeons must continuously aim to harmonize short- and long-term benefits with financial costs). We must also ensure quality patient outcomes while embracing innovations that will advance equitable cardiovascular care.
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Affiliation(s)
- Adom Netsanet
- Department of Surgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | - Jake Cotton
- Department of Surgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | | | - Jordan Hoffman
- Department of Surgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | - Muhammad Aftab
- Department of Surgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | - Brett Reece
- Department of Surgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | - Jessica Y Rove
- University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
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Adhami M, Martin NK, Maguire C, Courtenay AJ, Donnelly RF, Domínguez-Robles J, Larrañeta E. Drug loaded implantable devices to treat cardiovascular disease. Expert Opin Drug Deliv 2023; 20:507-522. [PMID: 36924328 DOI: 10.1080/17425247.2023.2190580] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
INTRODUCTION It is widely acknowledged that cardiovascular diseases (CVDs) continue to be the leading cause of death globally. Furthermore, CVDs are the leading cause of diminished quality of life for patients, frequently as a result of their progressive deterioration. Medical implants that release drugs into the body are active implants that do more than just provide mechanical support; they also have a therapeutic role. Primarily, this is achieved through the controlled release of active pharmaceutical ingredients (API) at the implementation site. AREAS COVERED In this review, the authors discuss drug-eluting stents, drug-eluting vascular grafts, and drug-eluting cardiac patches with the aim of providing a broad overview of the three most common types of cardiac implant. EXPERT OPINION Drug eluting implants are an ideal alternative to traditional drug delivery because they allow for accurate drug release, local drug delivery to the target tissue, and minimise the adverse side effects associated with systemic administration. Despite the fact that there are still challenges that need to be addressed, the ever-evolving new technologies are making the fabrication of drug eluting implants a rewarding therapeutic endeavour with the possibility for even greater advances.
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Affiliation(s)
| | | | | | - Aaron J Courtenay
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, UK
| | | | - Juan Domínguez-Robles
- School of Pharmacy, Queen's University Belfast, UK.,Department of Pharmacy and Pharmaceutical Technology, University of Seville, Seville, Spain
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Eivazi Zadeh Z, Eskandari F, Shafieian M, Solouk A, Haghbin Nazarpak M. The importance of polyurethane/carbon nanotubes composites fabrication method to mimic mechanical behavior of different types of soft tissues. Polym Bull (Berl) 2023. [DOI: 10.1007/s00289-023-04672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Li G, Yang T, Liu Y, Su H, Liu W, Fang D, Jin L, Jin F, Xu T, Duan C. The proteins derived from platelet-rich plasma improve the endothelialization and vascularization of small diameter vascular grafts. Int J Biol Macromol 2023; 225:574-587. [PMID: 36395946 DOI: 10.1016/j.ijbiomac.2022.11.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/26/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
Vascular transplantation has become an ideal substitute for heart and peripheral vascular bypass therapy and tissue-engineered vascular grafts (TEVGs) present an attractive potential solution for vascular surgery. However, small diameter (Ф < 6 mm) vascular do not have ideal TEVGs for clinical use. Platelet-rich plasma (PRP), a key source of bioactive molecules, has been confirmed to promote tissue repair and regeneration. In this study, we prepared PRP-loaded TEVGs (PRP-TEVGs) by electrospinning, investigated the characterization of TEVGs, and verified the effect of PRP-TEVGs in vivo and in vitro experiments. The results suggested that PRP-TEVGs had good biocompatibility, released growth factors stably, promoted cell proliferation and migration significantly, up-regulated the expression of endothelial NO synthase (eNOS) in functional vascular endothelial cells (VECs), and maintained the stability of the endothelial structure. In vivo experiments suggest that PRP can promote rapid endothelialization and reconstruction of TEVGs. Overall, this finding indicated that PRP could promote the rapid vascular endothelialization of small-diameter TEVGs by improving contractile vascular smooth muscle cells (VSMCs) regeneration, and maintaining the integrity and functionality of VECs.
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Affiliation(s)
- Guangxu Li
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Tao Yang
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Yanchao Liu
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Hengxian Su
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Wenchao Liu
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Dazhao Fang
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Lei Jin
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Fa Jin
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Tao Xu
- Tsinghua-Berkeley Shenzhen Institute (TBSI), Tsinghua University, Shenzhen 518055, China; East China Institute of Digital Medical Engineering, Shangrao 334000, China.
| | - Chuanzhi Duan
- Neurosurgery Center, Department of Cerebrovascular Surgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
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Williamson PN, Docherty PD, Khanafer A, Yazdi SG, Jermy M, Kabaliuk N, Murton B. Particle Image Velocimetry Evaluation of Hemodynamics Proximal to the Kissing Stent Configuration in the Aorto-Iliac Bifurcation. J Endovasc Ther 2022:15266028221141024. [PMID: 36458819 DOI: 10.1177/15266028221141024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE The kissing stent (KS) method is low-risk compared with open surgery techniques. It is often used to treat aorto-iliac occlusive disease (AIOD). Deployment of the KS geometry has a high technical success rate. However, stent patency reduces in the first 5 years potentially due to deleterious flow behavior. Potentially harmful hemodynamics due to the KS were investigated in vitro. METHODOLOGY A compliant phantom of the aorto-iliac bifurcation was manufactured. Two surrogate stent-grafts were deployed into the phantom in the KS configuration to investigate effects of the presence of the stents, including the compliance mismatch they cause, on the hemodynamics proximal and distal to the KS. The investigation used pulsatile flow through a flow circuit to simulate abdominal aortic flow. Particle image velocimetry (PIV) was used to quantify the hemodynamics. RESULTS PIV identified peak proximal and distal velocity in vitro was 0.71 and 1.40m·s-1, respectively, which were within physiological ranges. Throughout systole, flow appeared normal and undisturbed. A lumen wall collapse in the sagittal plane formed during late systole and continued to early diastole proximal to the aorto-iliac bifurcation, distal to the inlet stent position. The wall collapse led to disturbed flow proximal to the stented region in early diastole producing potential recirculation zones and abnormal flow patterns. CONCLUSION The normal systolic flow behavior indicates the KS configuration is unlikely to cause an inflammatory response of the arterial walls. The collapse has not been previously identified and may potentially cause long-term patency reduction. It requires further investigation. CLINICAL IMPACT The role of this article is to provide further insight into the haemodynamic behavior through a stented aorto-iliac artery. The results of this investigation will improve the understanding of the effects that using the kissing stent method may have on a patient and help to identify high risk regions that may require more detailed monitoring. This paper also develops the in vitro modelling techniques that will enable further research that cannot be carried out within patients.
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Affiliation(s)
- Petra N Williamson
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Paul D Docherty
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Adib Khanafer
- Vascular, Endovascular, & Renal Transplant Unit, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Sina G Yazdi
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Mark Jermy
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Benjamin Murton
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
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14
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Wang X, Chan V, Corridon PR. Acellular Tissue-Engineered Vascular Grafts from Polymers: Methods, Achievements, Characterization, and Challenges. Polymers (Basel) 2022; 14:polym14224825. [PMID: 36432950 PMCID: PMC9695055 DOI: 10.3390/polym14224825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022] Open
Abstract
Extensive and permanent damage to the vasculature leading to different pathogenesis calls for developing innovative therapeutics, including drugs, medical devices, and cell therapies. Innovative strategies to engineer bioartificial/biomimetic vessels have been extensively exploited as an effective replacement for vessels that have seriously malfunctioned. However, further studies in polymer chemistry, additive manufacturing, and rapid prototyping are required to generate highly engineered vascular segments that can be effectively integrated into the existing vasculature of patients. One recently developed approach involves designing and fabricating acellular vessel equivalents from novel polymeric materials. This review aims to assess the design criteria, engineering factors, and innovative approaches for the fabrication and characterization of biomimetic macro- and micro-scale vessels. At the same time, the engineering correlation between the physical properties of the polymer and biological functionalities of multiscale acellular vascular segments are thoroughly elucidated. Moreover, several emerging characterization techniques for probing the mechanical properties of tissue-engineered vascular grafts are revealed. Finally, significant challenges to the clinical transformation of the highly promising engineered vessels derived from polymers are identified, and unique perspectives on future research directions are presented.
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Affiliation(s)
- Xinyu Wang
- Department of Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Vincent Chan
- Department of Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Correspondence: (V.C.); (P.R.C.)
| | - Peter R. Corridon
- Department of Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Center for Biotechnology, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Correspondence: (V.C.); (P.R.C.)
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15
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Miceli GC, Palumbo FS, Bonomo FP, Zingales M, Licciardi M. Polybutylene Succinate Processing and Evaluation as a Micro Fibrous Graft for Tissue Engineering Applications. Polymers (Basel) 2022; 14:4486. [PMID: 36365480 PMCID: PMC9655432 DOI: 10.3390/polym14214486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 08/27/2023] Open
Abstract
A microfibrous tubular scaffold has been designed and fabricated by electrospinning using poly (1,4-butylene succinate) as biocompatible and biodegradable material. The scaffold morphology was optimized as a small diameter and micro-porous conduit, able to foster cell integration, adhesion, and growth while avoiding cell infiltration through the graft's wall. Scaffold morphology and mechanical properties were explored and compared to those of native conduits. Scaffolds were then seeded with adult normal human dermal fibroblasts to evaluate cytocompatibility in vitro. Haemolytic effect was evaluated upon incubation with diluted whole blood. The scaffold showed no delamination, and mechanical properties were in the physiological range for tubular conduits: elastic modulus (17.5 ± 1.6 MPa), ultimate tensile stress (3.95 ± 0.17 MPa), strain to failure (57 ± 4.5%) and suture retention force (2.65 ± 0.32 N). The shown degradation profile allows the graft to provide initial mechanical support and functionality while being colonized and then replaced by the host cells. This combination of features might represent a step toward future research on PBS as a biomaterial to produce scaffolds that provide structure and function over time and support host cell remodelling.
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Affiliation(s)
- Giovanni Carlo Miceli
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF), Università degli Studi di Palermo, 90123 Palermo, Italy
| | - Fabio Salvatore Palumbo
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF), Università degli Studi di Palermo, 90123 Palermo, Italy
| | - Francesco Paolo Bonomo
- Advanced Technology Network Center (ATeN Center), Università degli Studi di Palermo, 90128 Palermo, Italy
| | - Massimiliano Zingales
- Dipartimento di Ingegneria, Viale delle Scienze, Università degli Studi di Palermo, ed.8, 90128 Palermo, Italy
| | - Mariano Licciardi
- Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF), Università degli Studi di Palermo, 90123 Palermo, Italy
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16
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Alqahtani SS, Sloff M, Sawo P. Novel electrospun polyurethane grafts for vascular access in rats. J Vasc Access 2022:11297298221131393. [PMID: 36271613 DOI: 10.1177/11297298221131393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The purpose of this study is to develop a new and improved polyurethane (PU) graft using electrospinning and chemical modifications for hemodialysis patients, which will replace the current standard, polytetrafluoroethylene (PTFE) graft. The chemical modifications aim to improve hemocompatibility and reduce thrombogenicity and neointimal hyperplasia. METHOD The study population was randomized and divided equally into four groups; one control group received a PTFE graft, and three treatment groups received three different types of polyurethane grafts. Two duplex measurements were performed directly on the graft on the same locations, followed by a histologic examination. RESULTS In the first few days after the implantation animals lost some weight, it took a week to recover to pre-surgical weight. Throughout the 28 days, there was no significant difference between animals in wound, activity, and the general appearance. PTFE and PU A groups have lower compliance or reduced graft diameter due to neointimal hyperplasia development on Doppler interrogation. The histological analysis showed limited neointimal hyperplasia development and no excessive inflammatory response to any of the grafts. CONCLUSION This study demonstrates that animals with polyurethane grafts show better blood flow because the developed NIH was inconspicuous, as indicated by the different velocity measure than controls on Duplex and minimal NIH development microscopically.
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Affiliation(s)
- Saeed Saad Alqahtani
- Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
- Department of Biomedical Engineering, Maastricht University, Maastricht, The Netherlands
| | - Marije Sloff
- Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
- Department of Biomedical Engineering, Maastricht University, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Pamir Sawo
- Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
- Department of Biomedical Engineering, Maastricht University, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
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17
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Gorodkov AY, Tsygankov YM, Shepelev AD, Krasheninnikov SV, Zhorzholiani ST, Agafonov AV, Mamagulashvili VG, Savinov DV, Tenchurin TK, Chvalun SN. Influence of γ-Radiation on Mechanical Stability to Cyclic Loads Tubular Elastic Matrix of the Aorta. J Funct Biomater 2022; 13:192. [PMID: 36278661 PMCID: PMC9624334 DOI: 10.3390/jfb13040192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 04/13/2024] Open
Abstract
A significant drawback of the rigid synthetic vascular prostheses used in the clinic is the mechanical mismatch between the implant and the prosthetic vessel. When placing prostheses with radial elasticity, in which this deficiency is compensated, the integration of the graft occurs more favorably, so that signs of cell differentiation appear in the prosthesis capsule, which contributes to the restoration of vascular tone and the possibility of vasomotor reactions. Aortic prostheses fabricated by electrospinning from a blend of copolymers of vinylidene fluoride with hexafluoropropylene (VDF/HFP) had a biomechanical behavior comparable to the native aorta. In the present study, to ensure mechanical stability in the conditions of a living organism, the fabricated blood vessel prostheses (BVP) were cross-linked with γ-radiation. An optimal absorbed dose of 0.3 MGy was determined. The obtained samples were implanted into the infrarenal aorta of laboratory animals-Landrace pigs. Histological studies have shown that the connective capsule that forms around the prosthesis has signs of high tissue organization. This is evidenced by the cells of the fibroblast series located in layers oriented along and across the prosthesis, similar to the orientation of cells in a biological arterial vessel.
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Affiliation(s)
- Alexander Yu. Gorodkov
- A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Rublevskoye Highway 135, 121552 Moscow, Russia
| | - Yuriy M. Tsygankov
- A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Rublevskoye Highway 135, 121552 Moscow, Russia
| | - Alexey D. Shepelev
- National Research Centre “Kurchatov Institute”, Akademika Kurchatova pl. 1, 123182 Moscow, Russia
| | - Sergey V. Krasheninnikov
- National Research Centre “Kurchatov Institute”, Akademika Kurchatova pl. 1, 123182 Moscow, Russia
| | - Shota T. Zhorzholiani
- A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Rublevskoye Highway 135, 121552 Moscow, Russia
| | - Andrey V. Agafonov
- A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Rublevskoye Highway 135, 121552 Moscow, Russia
| | | | - Dmitriy V. Savinov
- National Research Centre “Kurchatov Institute”, Akademika Kurchatova pl. 1, 123182 Moscow, Russia
| | - Timur Kh. Tenchurin
- National Research Centre “Kurchatov Institute”, Akademika Kurchatova pl. 1, 123182 Moscow, Russia
| | - Sergey N. Chvalun
- National Research Centre “Kurchatov Institute”, Akademika Kurchatova pl. 1, 123182 Moscow, Russia
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18
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Zia AW, Liu R, Wu X. Structural design and mechanical performance of composite vascular grafts. Biodes Manuf 2022. [DOI: 10.1007/s42242-022-00201-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractThis study reviews the state of the art in structural design and the corresponding mechanical behaviours of composite vascular grafts. We critically analyse surface and matrix designs composed of layered, embedded, and hybrid structures along the radial and longitudinal directions; materials and manufacturing techniques, such as tissue engineering and the use of textiles or their combinations; and the corresponding mechanical behaviours of composite vascular grafts in terms of their physical–mechanical properties, especially their stress–strain relationships and elastic recovery. The role of computational studies is discussed with respect to optimizing the geometrics designs and the corresponding mechanical behaviours to satisfy specialized applications, such as those for the aorta and its subparts. Natural and synthetic endothelial materials yield improvements in the mechanical and biological compliance of composite graft surfaces with host arteries. Moreover, the diameter, wall thickness, stiffness, compliance, tensile strength, elasticity, and burst strength of the graft matrix are determined depending on the application and the patient. For composite vascular grafts, hybrid architectures are recommended featuring multiple layers, dimensions, and materials to achieve the desired optimal flexibility and function for complying with user-specific requirements. Rapidly emerging artificial intelligence and big data techniques for diagnostics and the three-dimensional (3D) manufacturing of vascular grafts will likely yield highly compliant, subject-specific, long-lasting, and economical vascular grafts in the near-future.
Graphic abstract
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19
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Computationally Efficient Concept of Representative Directions for Anisotropic Fibrous Materials. Polymers (Basel) 2022; 14:polym14163314. [PMID: 36015572 PMCID: PMC9416447 DOI: 10.3390/polym14163314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The concept of representative directions allows for automatic generation of multi-axial constitutive equations, starting from simplified uni-axial material models. In this paper, a modification of the concept is considered suitable for the analysis of fibrous polymeric materials, which are anisotropic in the as-received state. The modification of the concept incorporates an orientation probability density function (OPDF), which explicitly accounts for the material anisotropy. Two versions of the concept are available. The first version utilizes the homogeneous distribution of the representative directions, with the entire anisotropy being contained in the weighting factors. The second encapsulates the anisotropy in the distribution of the representative directions. Due to its nature, the second version allows for a more efficient use of computational power. To promote this efficient version of the concept, we present new algorithms generating required sets of representative directions that match a given OPDF. These methods are based (i) on the minimization of a potential energy, (ii) on the equilibration method, and (iii) on the use of Voronoi cells. These three methods are tested and compared in terms of various OPDFs. The applicability of the computationally efficient modeling method to mechanical behavior of an anisotropic polymeric material is demonstrated. In particular, a calibration procedure is suggested for the practically important case when the OPDF is not known a-priori.
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20
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Grémare A, Thibes L, Gluais M, Torres Y, Potart D, Da Silva N, Dusserre N, Fénelon M, Senthilhes L, Lacomme S, Svahn I, Gontier É, Fricain JC, L'Heureux N. Development of a vascular substitute produced by weaving yarn made from human amniotic membrane. Biofabrication 2022; 14. [PMID: 35896106 DOI: 10.1088/1758-5090/ac84ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/27/2022] [Indexed: 11/12/2022]
Abstract
Because synthetic vascular prostheses perform poorly in small-diameter revascularization, biological vascular substitutes are being developed as an alternative. Although their in vivo results are promising, their production involves long, complex, and expensive tissue engineering methods. To overcome these limitations, we propose an innovative approach that combines the human amniotic membrane (HAM), which is a widely available and cost-effective biological raw material, with a rapid and robust textile-inspired assembly strategy. Fetal membranes were collected after cesarean deliveries at term. Once isolated by dissection, HAM sheets were cut into ribbons that could be further processed by twisting into threads. Characterization of the HAM yarns (both ribbons and threads) showed that their physical and mechanical properties could be easily tuned. Since our clinical strategy will be to provide an off-the-shelf allogeneic implant, we studied the effects of decellularization and/or gamma sterilization on the histological, mechanical, and biological properties of HAM ribbons. Gamma irradiation of hydrated HAMs, with or without decellularization, did not interfere with the ability of the matrix to support endothelium formation in vitro. Finally, our HAM-based, woven tissue-engineered vascular grafts (TEVGs) exhibited clinically relevant mechanical properties. Thus, this study demonstrates that human, completely biological, allogeneic, small-diameter TEVGs can be produced from HAM, thereby avoiding costly cell culture and bioreactors.
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Affiliation(s)
- Agathe Grémare
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Lisa Thibes
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Maude Gluais
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Yoann Torres
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Diane Potart
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Nicolas Da Silva
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Nathalie Dusserre
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Mathilde Fénelon
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Loïc Senthilhes
- Obstetrics and Gynecology, CHU de Bordeaux, Hopital Pellegrin, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33076, FRANCE
| | - Sabrina Lacomme
- University of Bordeaux, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33000, FRANCE
| | - Isabelle Svahn
- University of Bordeaux, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33000, FRANCE
| | - Étienne Gontier
- University of Bordeaux, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33000, FRANCE
| | - Jean-Christophe Fricain
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Nicolas L'Heureux
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
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21
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Kim Y, Kim CH, Kim TH, Park SH. Soft Biomimetic 3D Free-Form Artificial Vascular Graft Using a Highly Uniform Microspherical Porous Structure. ACS APPLIED MATERIALS & INTERFACES 2022; 14:29588-29598. [PMID: 35730532 DOI: 10.1021/acsami.2c05839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study presents a biomimetic 3D customizable artificial vascular graft with a highly porous and uniform microscale structure. The structural features were obtained by dip coating of a highly close-packed microsphere suspension on a 3D printed sacrificial template. Considering the structured arrangement of microspherical porogens in the coating layer, the microsphere-leached constructs showed higher uniformity and porosity than the conventionally particulate-leached structures, leading to ultrasoft mechanical compliance. Considering biomechanical compatibility, the resulting elastic moduli were at the sub-MPa level, comparable with those of native vascular tissues. In addition, the developed porous graft was reinforced selectively at the edge regions using a nonporous coating to secure its practical sutureability for clinical use. The sufficiently low cytotoxicity was clinically confirmed to alleviate the stiffness mismatch issues at the anastomotic interface between the native tissue and the artificial graft, thus overcoming the relevant clinical complications. Furthermore, the overall superior properties could be implemented on the 3D printed template for patient-specific medicare, thus implying the manufacturability of patient-specific vascular grafts.
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Affiliation(s)
- Yuseok Kim
- School of Mechanical Engineering, Pusan National University, Busan 46241, Republic of Korea
| | - Chae Hwa Kim
- Advanced Textile R&D Department, Korea Institute of Industrial Technology, Ansan 15588, Republic of Korea
| | - Tae Hee Kim
- Advanced Textile R&D Department, Korea Institute of Industrial Technology, Ansan 15588, Republic of Korea
| | - Suk Hee Park
- School of Mechanical Engineering, Pusan National University, Busan 46241, Republic of Korea
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22
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Zizhou R, Wang X, Houshyar S. Review of Polymeric Biomimetic Small-Diameter Vascular Grafts to Tackle Intimal Hyperplasia. ACS OMEGA 2022; 7:22125-22148. [PMID: 35811906 PMCID: PMC9260943 DOI: 10.1021/acsomega.2c01740] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
Small-diameter artificial vascular grafts (SDAVG) are used to bypass blood flow in arterial occlusive diseases such as coronary heart or peripheral arterial disease. However, SDAVGs are plagued by restenosis after a short while due to thrombosis and the thickening of the neointimal wall known as intimal hyperplasia (IH). The specific causes of IH have not yet been deduced; however, thrombosis formation due to bioincompatibility as well as a mismatch between the biomechanical properties of the SDAVG and the native artery has been attributed to its initiation. The main challenges that have been faced in fabricating SDAVGs are facilitating rapid re-endothelialization of the luminal surface of the SDAVG and replicating the complex viscoelastic behavior of the arteries. Recent strategies to combat IH formation have been mostly based on imitating the natural structure and function of the native artery (biomimicry). Thus, most recently, developed grafts contain a multilayered structure with a designated function for each layer. This paper reviews the current polymeric, biomimetic SDAVGs in preventing the formation of IH. The materials used in fabrication, challenges, and strategies employed to tackle IH are summarized and discussed, and we focus on the multilayered structure of current SDAVGs. Additionally, the future aspects in this area are pointed out for researchers to consider in their endeavor.
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Affiliation(s)
- Rumbidzai Zizhou
- Center
for Materials Innovation and Future Fashion (CMIFF), School of Fashion
and Textiles, RMIT University, Brunswick 3056, Australia
| | - Xin Wang
- Center
for Materials Innovation and Future Fashion (CMIFF), School of Fashion
and Textiles, RMIT University, Brunswick 3056, Australia
| | - Shadi Houshyar
- School
of Engineering, RMIT University, Melbourne 3000, Australia
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23
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Li J, Xue C, Wang H, Dong S, Yang Z, Cao Y, Zhao B, Cheng B, Xie X, Mo X, Jiang W, Yuan H, Pan J. Hybrid Nanofibrous Composites with Anisotropic Mechanics and Architecture for Tendon/Ligament Repair and Regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2201147. [PMID: 35686342 DOI: 10.1002/smll.202201147] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/12/2022] [Indexed: 06/15/2023]
Abstract
Rupture of tendons and ligaments (T/L) is a major clinical challenge due to T/L possess anisotropic mechanical properties and hierarchical structures. Here, to imitate these characteristics, an approach is presented by fabricating hybrid nanofibrous composites. First, hybrid fiber-reinforced yarns are fabricated via successively electrospinning poly(L-lactide-co-ε-caprolactone) (PLCL) and gelatin (Ge) nanofibers onto polyethylene terephthalate (PET) fibers to improve biodurability and biocompatibility. Then, by comparing different manufacturing methods, the knitted structure succeeds in simulating anisotropic mechanical properties, even being stronger than natural ligaments, and possessing comfort compliance superior to clinically used ligament advanced reinforcement system (LARS) ligament. Moreover, after inoculation with tendon-derived stem cells and transplantation in vivo, hybrid nanofibrous composites are integrated with native tendons to guide surrounding tissue ingrowth due to the highly interconnected and porous structure. The knitted hybrid nanofibrous composites are also ligamentized and remodeled in vivo to promote tendon regeneration. Specifically, after the use of optimized anisotropic hybrid nanofibrous composites to repair tendon, the deposition of tendon-associated extracellular matrix proteins is more significant. Thus, this study indicates a strategy of manufacturing anisotropic hybrid nanofibrous composites with superior mechanical properties and good histocompatibility for clinical reconstruction.
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Affiliation(s)
- Jun Li
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Chao Xue
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Hao Wang
- Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, P. R. China
| | - Shiyan Dong
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA
| | - Zhaogang Yang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA
| | - Yuting Cao
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P. R. China
| | - Binan Zhao
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Biao Cheng
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Xianrui Xie
- School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai, 264003, P. R. China
| | - Xiumei Mo
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, 201620, P. R. China
| | - Wen Jiang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA
| | - Hengfeng Yuan
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P. R. China
| | - Jianfeng Pan
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
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24
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Vahabli E, Mann J, Heidari BS, Lawrence‐Brown M, Norman P, Jansen S, Pardo EDJ, Doyle B. The Technological Advancement to Engineer Next-Generation Stent-Grafts: Design, Material, and Fabrication Techniques. Adv Healthc Mater 2022; 11:e2200271. [PMID: 35481675 DOI: 10.1002/adhm.202200271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/04/2022] [Indexed: 12/12/2022]
Abstract
Endovascular treatment of aortic disorders has gained wide acceptance due to reduced physiological burden to the patient compared to open surgery, and ongoing stent-graft evolution has made aortic repair an option for patients with more complex anatomies. To date, commercial stent-grafts are typically developed from established production techniques with simple design structures and limited material ranges. Despite the numerous updated versions of stent-grafts by manufacturers, the reoccurrence of device-related complications raises questions about whether the current manfacturing methods are technically able to eliminate these problems. The technology trend to produce efficient medical devices, including stent-grafts and all similar implants, should eventually change direction to advanced manufacturing techniques. It is expected that through recent advancements, especially the emergence of 4D-printing and smart materials, unprecedented features can be defined for cardiovascular medical implants, like shape change and remote battery-free self-monitoring. 4D-printing technology promises adaptive functionality, a highly desirable feature enabling printed cardiovascular implants to physically transform with time to perform a programmed task. This review provides a thorough assessment of the established technologies for existing stent-grafts and provides technical commentaries on known failure modes. They then discuss the future of advanced technologies and the efforts needed to produce next-generation endovascular implants.
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Affiliation(s)
- Ebrahim Vahabli
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
| | - James Mann
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
| | - Behzad Shiroud Heidari
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies University of Western Australia Perth 6009 Australia
| | | | - Paul Norman
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- Medical School The University of Western Australia Perth 6009 Australia
| | - Shirley Jansen
- Curtin Medical School Curtin University Perth WA 6102 Australia
- Department of Vascular and Endovascular Surgery Sir Charles Gairdner Hospital Perth WA 6009 Australia
- Heart and Vascular Research Institute Harry Perkins Medical Research Institute Perth WA 6009 Australia
| | - Elena de Juan Pardo
- School of Engineering The University of Western Australia Perth 6009 Australia
- School of Mechanical Medical and Process Engineering Queensland University of Technology Brisbane Queensland 4059 Australia
- T3mPLATE Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth WA 6009 Australia
| | - Barry Doyle
- Vascular Engineering Laboratory Harry Perkins Institute of Medical Research QEII Medical Centre Nedlands and the UWA Centre for Medical Research The University of Western Australia Perth 6009 Australia
- School of Engineering The University of Western Australia Perth 6009 Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies University of Western Australia Perth 6009 Australia
- British Heart Foundation Centre for Cardiovascular Science The University of Edinburgh Edinburgh EH16 4TJ UK
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Pure Chitosan Biomedical Textile Fibers from Mixtures of Low- and High-Molecular Weight Bidisperse Polymer Solutions: Processing and Understanding of Microstructure-Mechanical Properties' Relationship. Int J Mol Sci 2022; 23:ijms23094767. [PMID: 35563158 PMCID: PMC9105658 DOI: 10.3390/ijms23094767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
Natural polymers, as extracted from biomass, may exhibit large macromolecular polydispersity. We investigated the impact of low molar mass chitosan (LMW, DPw~115) on the properties of chitosan fibers obtained by wet spinning of chitosan solutions with bimodal distributions of molar masses. The fiber crystallinity index (CrI) was assessed by synchrotron X-ray diffraction and the mechanical properties were obtained by uniaxial tensile tests. The LMW chitosan showed to slightly increase the crystallinity index in films which were initially processed from the bimodal molar mass chitosan solutions, as a result of increased molecular mobility and possible crystal nucleating effects. Nevertheless, the CrI remained almost constant or slightly decreased in stretched fibers at increasing content of LMW chitosan in the bidisperse chitosan collodion. The ultimate mechanical properties of fibers were altered by the addition of LMW chitosan as a result of a decrease of entanglement density and chain orientation in the solid state. An increase of crystallinity might not be expected from LMW chitosan with a still relatively high degree of polymerization (DPw ≥ 115). Instead, different nucleation agents-either smaller molecules or nanoparticles-should be used to improve the mechanical properties of chitosan fibers for textile applications.
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Kauser K, Warner KS, Anderson B, Keyes ED, Hayes RB, Kawamoto E, Perkins DH, Scott R, Isaacson J, Haberer B, Spaans A, Utecht R, Hauser H, Roberts AG, Greenberg M. Creating a Natural Vascular Scaffold by Photochemical Treatment of the Extracellular Matrix for Vascular Applications. Int J Mol Sci 2022; 23:ijms23020683. [PMID: 35054866 PMCID: PMC8775700 DOI: 10.3390/ijms23020683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 02/01/2023] Open
Abstract
The development of bioscaffolds for cardiovascular medical applications, such as peripheral artery disease (PAD), remains to be a challenge for tissue engineering. PAD is an increasingly common and serious cardiovascular illness characterized by progressive atherosclerotic stenosis, resulting in decreased blood perfusion to the lower extremities. Percutaneous transluminal angioplasty and stent placement are routinely performed on these patients with suboptimal outcomes. Natural Vascular Scaffolding (NVS) is a novel treatment in the development for PAD, which offers an alternative to stenting by building on the natural structural constituents in the extracellular matrix (ECM) of the blood vessel wall. During NVS treatment, blood vessels are exposed to a photoactivatable small molecule (10-8-10 Dimer) delivered locally to the vessel wall via an angioplasty balloon. When activated with 450 nm wavelength light, this therapy induces the formation of covalent protein–protein crosslinks of the ECM proteins by a photochemical mechanism, creating a natural scaffold. This therapy has the potential to reduce the need for stent placement by maintaining a larger diameter post-angioplasty and minimizing elastic recoil. Experiments were conducted to elucidate the mechanism of action of NVS, including the molecular mechanism of light activation and the impact of NVS on the ECM.
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Affiliation(s)
- Katalin Kauser
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
- Correspondence: ; Tel.: +1-415-527-9892
| | - Kevin S. Warner
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Blake Anderson
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Edgar Dalles Keyes
- Department of Chemistry, University of Utah, 315 South 1400 East, Salt Lake City, UT 84112, USA; (E.D.K.); (A.G.R.)
| | - RB Hayes
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Eric Kawamoto
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - DH Perkins
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Robert Scott
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Jim Isaacson
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Barb Haberer
- Alumend, LLC, 4800 N. Career Avenue, Suite #108, Sioux Falls, SD 57107, USA; (B.H.); (A.S.); (R.U.)
| | - Ann Spaans
- Alumend, LLC, 4800 N. Career Avenue, Suite #108, Sioux Falls, SD 57107, USA; (B.H.); (A.S.); (R.U.)
| | - Ronald Utecht
- Alumend, LLC, 4800 N. Career Avenue, Suite #108, Sioux Falls, SD 57107, USA; (B.H.); (A.S.); (R.U.)
| | - Hank Hauser
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Andrew George Roberts
- Department of Chemistry, University of Utah, 315 South 1400 East, Salt Lake City, UT 84112, USA; (E.D.K.); (A.G.R.)
| | - Myles Greenberg
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
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Abstract
There is a tremendous clinical need for synthetic vascular grafts either for bypass procedure or vascular access during hemodialysis. However, currently, there is no small-diameter vascular graft commercially available to meet long-term patency requirement due to frequent thrombus formation and intimal hyperplasia. This chapter describes the fabrication of electrospun small-diameter polycarbonate-urethane (PCU) vascular graft with a biomimetic fibrous structure. Additionally, the surface of the vascular graft is aminated via plasma treatment for the subsequently end-point heparin immobilization to enhance antithrombosis property.
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28
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Yang W, Li Y, Xiao Y, Hou J, Tang K, Pei Y. Construction of porous cellulose tubes and the evaluations of mechanical properties and cytocompatibility. J Appl Polym Sci 2021. [DOI: 10.1002/app.51399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Wen Yang
- School of Materials Science and Engineering Zhengzhou University Zhengzhou China
| | - Yifan Li
- School of Materials Science and Engineering Zhengzhou University Zhengzhou China
| | - Yuelong Xiao
- School of Materials Science and Engineering Zhengzhou University Zhengzhou China
| | - Jianhua Hou
- School of Mechanics Science Zhengzhou University Zhengzhou China
- National Center for International Research of Micro‐nano Molding Technology, Zhengzhou University Zhengzhou China
| | - Keyong Tang
- School of Materials Science and Engineering Zhengzhou University Zhengzhou China
| | - Ying Pei
- School of Materials Science and Engineering Zhengzhou University Zhengzhou China
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29
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A Computational Framework Examining the Mechanical Behaviour of Bare and Polymer-Covered Self-Expanding Laser-Cut Stents. Cardiovasc Eng Technol 2021; 13:466-480. [PMID: 34850370 DOI: 10.1007/s13239-021-00597-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/16/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Polymer covered stents have demonstrated promising clinical outcomes with improved patency rates compared to traditional bare-metal stents. However, little is known on the mechanical implication of stent covering. This study aims to provide insight into the role of a polymeric cover on the biomechanical performance of self-expanding laser-cut stents through a combined experimental-computational approach. METHODS Experimental bench top tests were conducted on bare and covered versions of a commercial stent to evaluate the radial, axial and bending response. In parallel, a computational framework with a novel covering strategy was developed that accurately predicts stent mechanical performance. Different stent geometries and polymer materials were also considered to further improve understanding on covered stent mechanics. RESULTS Results show that stent covering causes increased initial axial stiffness and up to 60% greater radial resistive force at small crimp diameters as the cover folds and self-contacts. The incorporation of a cover allows stent designs without interconnecting struts, thereby providing improved flexibility without compromising radial force. It was also shown that use of a stiffer PET polymeric covering material caused significant alterations to the radial and axial response, with the initial axial stiffness increasing six-fold and the maximum radial resistive force increasing four-fold compared to a PTFE-PU covered stent. CONCLUSION This study demonstrates that stent covering has a substantial effect on the overall stent mechanical performance and highlights the importance of considering the mechanical properties of the combined cover and stent.
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30
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Krishnan AG, Joseph J, C. R. R, Nair SV, Nair M, Menon D. Silk-based bilayered small diameter woven vascular conduits for improved mechanical and cellular characteristics. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2021.1999954] [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]
Affiliation(s)
- Aarya G. Krishnan
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
| | - John Joseph
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Reshmi C. R.
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Shantikumar V. Nair
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Manitha Nair
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Deepthy Menon
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
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31
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Bioengineering silk into blood vessels. Biochem Soc Trans 2021; 49:2271-2286. [PMID: 34495327 DOI: 10.1042/bst20210359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/05/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
The rising incidence of cardiovascular disease has increased the demand for small diameter (<6 mm) synthetic vascular grafts for use in bypass surgery. Clinically available synthetic grafts (polyethylene terephthalate and expanded polytetrafluorethylene) are incredibly strong, but also highly hydrophobic and inelastic, leading to high rates of failure when used for small diameter bypass. The poor clinical outcomes of commercial synthetic grafts in this setting have driven significant research in search of new materials that retain favourable mechanical properties but offer improved biocompatibility. Over the last several decades, silk fibroin derived from Bombyx mori silkworms has emerged as a promising biomaterial for use in vascular applications. Progress has been driven by advances in silk manufacturing practices which have allowed unprecedented control over silk strength, architecture, and the ensuing biological response. Silk can now be manufactured to mimic the mechanical properties of native arteries, rapidly recover the native endothelial cell layer lining vessels, and direct positive vascular remodelling through the regulation of local inflammatory responses. This review summarises the advances in silk purification, processing and functionalisation which have allowed the production of robust vascular grafts with promise for future clinical application.
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32
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Peritoneal Pre-conditioning Method for In Vivo Vascular Graft Maturation Utilizing a Porous Pouch. Methods Mol Biol 2021. [PMID: 34591301 DOI: 10.1007/978-1-0716-1708-3_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Tissue-engineered vascular grafts (TEVGs) require strategies to allow graft remodeling but avoid stenosis and loss of graft mechanics. A variety of promising biomaterials and methods to incorporate cells have been tested, but intimal hyperplasia and graft thrombosis are still concerning when grafting in small-diameter arteries. Here, we describe a strategy using the peritoneal cavity as an "in vivo" bioreactor to recruit autologous cells to electrospun conduits, which can improve the in vivo response after aortic grafting. We focus on the methods for a novel hydrogel pouch design to enclose the electrospun conduits that can avoid peritoneal adhesion but still allow infiltration of peritoneal fluid and cells needed to provide benefits when subsequently grafting in the aorta.
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33
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Concannon J, Moerman KM, Hynes N, Sultan S, McGarry JP. Influence of shape-memory stent grafts on local aortic compliance. Biomech Model Mechanobiol 2021; 20:2373-2392. [PMID: 34541627 PMCID: PMC8595172 DOI: 10.1007/s10237-021-01514-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022]
Abstract
The effect of repair techniques on the biomechanics of the aorta is poorly understood, resulting in significant levels of postoperative complications for patients worldwide. This study presents a computational analysis of the influence of Nitinol-based devices on the biomechanical performance of a healthy patient-specific human aorta. Simulations reveal that Nitinol stent-grafts stretch the artery wall so that collagen is stretched to a straightened high-stiffness configuration. The high-compliance regime (HCR) associated with low diastolic lumen pressure is eliminated, and the artery operates in a low-compliance regime (LCR) throughout the entire cardiac cycle. The slope of the lumen pressure–area curve for the LCR post-implantation is almost identical to that of the native vessel during systole. This negligible change from the native LCR slope occurs because the stent-graft increases its diameter from the crimped configuration during deployment so that it reaches a low-stiffness unloading plateau. The effective radial stiffness of the implant along this unloading plateau is negligible compared to the stiffness of the artery wall. Provided the Nitinol device unloads sufficiently during deployment to the unloading plateau, the degree of oversizing has a negligible effect on the pressure–area response of the vessel, as each device exerts approximately the same radial force, the slope of which is negligible compared to the LCR slope of the native artery. We show that 10% oversizing based on the observed diastolic diameter in the mid descending thoracic aorta results in a complete loss of contact between the device and the wall during systole, which could lead to an endoleak and stent migration. 20% oversizing reaches the Dacron enforced area limit (DEAL) during the pulse pressure and results in an effective zero-compliance in the later portion of systole.
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Affiliation(s)
- J Concannon
- Biomedical Engineering, College of Engineering and Informatics, National University of Ireland, Galway, Ireland
| | - K M Moerman
- Biomedical Engineering, College of Engineering and Informatics, National University of Ireland, Galway, Ireland
| | - N Hynes
- Western Vascular Institute, National University of Ireland Galway, Galway, Ireland
| | - S Sultan
- Western Vascular Institute, National University of Ireland Galway, Galway, Ireland
| | - J P McGarry
- Biomedical Engineering, College of Engineering and Informatics, National University of Ireland, Galway, Ireland.
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34
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Jiang C, Wang K, Liu Y, Zhang C, Wang B. Application of textile technology in tissue engineering: A review. Acta Biomater 2021; 128:60-76. [PMID: 33962070 DOI: 10.1016/j.actbio.2021.04.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/26/2021] [Accepted: 04/26/2021] [Indexed: 12/14/2022]
Abstract
One of the key elements in tissue engineering is to design and fabricate scaffolds with tissue-like properties. Among various scaffold fabrication methods, textile technology has shown its unique advantages in mimicking human tissues' properties such as hierarchical, anisotropic, and strain-stiffening properties. As essential components in textile technology, textile patterns affect the porosity, architecture, and mechanical properties of textile-based scaffolds. However, the potential of various textile patterns has not been fully explored when fabricating textile-based scaffolds, and the effect of different textile patterns on scaffold properties has not been thoroughly investigated. This review summarizes textile technology development and highlights its application in tissue engineering to facilitate the broader application of textile technology, especially various textile patterns in tissue engineering. The potential of using different textile methods such as weaving, knitting, and braiding to mimic properties of human tissues is discussed, and the effect of process parameters in these methods on fabric properties is summarized. Finally, perspectives on future directions for explorations are presented. STATEMENT OF SIGNIFICANCE: Recently, biomedical engineers have applied textile technology to fabricate scaffolds for tissue engineering applications. Various textile methods, especially weaving, knitting, and braiding, enables engineers to customize the physical, mechanical, and biological properties of scaffolds. However, most textile-based scaffolds only use simple textile patterns, and the effect of different textile patterns on scaffold properties has not been thoroughly investigated. In this review, we cover for the first time the effect of process parameters in different textile methods on fabric properties, exploring the potential of using different textile methods to mimic properties of human tissues. Previous advances in textile technology are presented, and future directions for explorations are presented, hoping to facilitate new breakthroughs of textile-based tissue engineering.
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Affiliation(s)
- Chen Jiang
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States; Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, United States
| | - Kan Wang
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, United States.
| | - Yi Liu
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, United States; School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30318, United States
| | - Chuck Zhang
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, United States; H. Milton Stewart School of Industrial and System Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States
| | - Ben Wang
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States; Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, United States; H. Milton Stewart School of Industrial and System Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States
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35
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Byrne O, Coulter F, Roche ET, O'Cearbhaill ED. In silico design of additively manufacturable composite synthetic vascular conduits and grafts with tuneable compliance. Biomater Sci 2021; 9:4343-4355. [PMID: 33724267 DOI: 10.1039/d0bm02169e] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Benchtop testing of endovascular medical devices under accurately simulated physiological conditions is a critical part of device evaluation prior to clinical assessment. Currently, glass, acrylic and silicone vascular models are predominantly used as anatomical simulator test beds for in vitro testing. However, most current models lack the ability to mimic the non-linear radial compliance of native vessels and are typically limited to being compliance-matched at a single mean pressure comparison point or not at all. Hence, a degree of caution needs to be shown when analysing results from such models under simulated physiological or pathophysiological conditions. Similarly, the clinical translation of proposed biomimetic compliance-matched vascular grafts has undoubtedly been curtailed due to performance and material limitations. Here, we propose a new design for synthetic vessels where compliance can be precisely modulated across a wide physiological pressure range by customising design parameters. Building on previously demonstrated methods of 3D printing composite compliant cylindrical structures, we demonstrate proof of principle in creating composite vascular constructs designed via a finite element model. Our constructs are 3D printable and consist of a soft silicone matrix with embedded polyurethane fibres. The fibre layer consists of circumferential sinusoidal waves with an amplitude that can be altered to result in tuneable internal radial compliances of 5.2-15.9%/mmHg × 10-2 at a mean pressure of 100 mmHg. Importantly, the design presented here allows preservation of the non-linear exponentially decaying compliance curve of native arteries and veins with an increasing mean pressure. This model offers a design toolbox for 3D printable vascular models that offer biomimetic compliance. The robust nature of this model will lead to rapidly accelerating the design process for biomimetic vascular anatomical simulators, lumped parameter model flow loops, endovascular device benchtop testbeds, and compliance-matched synthetic grafts.
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Affiliation(s)
- Oisín Byrne
- School of Mechanical and Materials Engineering, UCD Centre for Biomedical Engineering, University College Dublin, Belfield, Ireland and CÚRAM, the SFI Research Centre for Medical Devices, Ireland
| | - Fergal Coulter
- School of Mechanical and Materials Engineering, UCD Centre for Biomedical Engineering, University College Dublin, Belfield, Ireland and Complex Materials, Department of Materials, ETH Zurich, Zurich, Switzerland
| | - Ellen T Roche
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA and Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Eoin D O'Cearbhaill
- School of Mechanical and Materials Engineering, UCD Centre for Biomedical Engineering, University College Dublin, Belfield, Ireland and CÚRAM, the SFI Research Centre for Medical Devices, Ireland
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36
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Maleckis K, Kamenskiy A, Lichter EZ, Oberley-Deegan R, Dzenis Y, MacTaggart J. Mechanically tuned vascular graft demonstrates rapid endothelialization and integration into the porcine iliac artery wall. Acta Biomater 2021; 125:126-137. [PMID: 33549808 DOI: 10.1016/j.actbio.2021.01.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 12/12/2022]
Abstract
Mechanical properties of vascular grafts likely play important roles in healing and tissue regeneration. Healthy arteries are compliant at low pressures but stiffen rapidly with increasing load, ensuring sufficient volumetric expansion without overstretching the vessel. Commercial synthetic vascular grafts are stiff and unable to expand under physiologic loads, which may result in altered hemodynamics, deleterious cellular responses, and compromised clinical performance. The goal of this study was to develop an Elastomeric Nanofibrillar Graft (ENG) with artery-tuned nonlinear compliance and compare its healing responses to conventional expanded polytetrafluoroethylene (ePTFE) grafts in a porcine iliac artery model. Human and porcine iliac arteries were mechanically characterized, and an ENG with similar properties was created by utilizing residual strains within electrospun nanofibers. The ENG was tested for implantation suitability and implanted onto n = 5 domestic swine iliac arteries, with control ePTFE grafts implanted onto the contralateral iliac arteries. After two weeks in vivo, all iliac arteries and grafts remained patent with no signs of thrombosis or dilation. The mechanically tuned ENG implants exhibited a more confluent CD31-positive cell monolayer (1.53 ± 0.73 µm2/mm vs 0.52 ± 0.55 µm2/mm, p = 0.042) on the graft lumenal surface and a higher fraction of αSMA-positive cells (16.2 ± 8.6% vs 1.4 ± 0.7%, p = 0.018) within the graft wall than the ePTFE controls. Despite heavy cellular infiltration, the ENG retained its artery-like mechanical characteristics after two weeks in vivo. These short-term results demonstrate potential advantages of mechanically tuned biomimetic vascular grafts over standard ePTFE grafts. STATEMENT OF SIGNIFICANCE: Off-the-shelf synthetic vascular grafts are often the only option available for treating advanced stages of vascular disease. Despite significant efforts devoted to improving their biochemical characteristics, synthetic peripheral arterial grafts continue to demonstrate poor clinical outcomes leading to costly reinterventions. Here, we hypothesized that a synthetic vascular graft with elastomeric mechanical properties tuned to a healthy peripheral artery promotes better healing responses than a synthetic stiff graft. To test this hypothesis, we developed an Elastomeric Nanofibrillar Graft (ENG) with artery-tuned mechanical properties and compared its performance to a commercial ePTFE graft in a preclinical porcine iliac artery model. Our results suggest that mechanically tuned ENGs can offer better healing responses, potentially leading to better clinical outcomes for peripheral arterial repairs.
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37
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Magnan L, Kawecki F, Labrunie G, Gluais M, Izotte J, Marais S, Foulc MP, Lafourcade M, L'Heureux N. In vivo remodeling of human cell-assembled extracellular matrix yarns. Biomaterials 2021; 273:120815. [PMID: 33894404 DOI: 10.1016/j.biomaterials.2021.120815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/22/2022]
Abstract
Cell-assembled extracellular matrix (CAM) has been used to produce vascular grafts. While these completely biological vascular grafts performed well in clinical trials, the in vivo remodeling and inflammatory response of this truly "bio" material has not yet been investigated. In this study, human CAM yarns were implanted subcutaneously in nude rats to investigate the innate immune response to this matrix. The impact of processing steps relevant to yarn manufacturing was evaluated (devitalization, decellularization, gamma sterilization, and twisting). We observed that yarns were still present after six months, and were integrated into a non-inflamed loose connective tissue. The CAM was repopulated by fibroblastic cells and blood vessels. While other yarns caused minor peripheral inflammation at an early stage (two weeks of implantation), gamma sterilization triggered a more intense host response dominated by the presence of M1 macrophages. The inflammatory response was resolved at six months. Yarn mechanical strength was decreased two weeks after implantation except for the more compact "twisted" yarn. While the strength of other yarns was stable after initial remodeling, the gamma-sterilized yarn continued to lose mechanical strength over time and was weaker than devitalized (control) yarns at six months. This is the first study to formally demonstrate that devitalized human CAM is very long-lived in vivo and does not trigger a degradative response, but rather is very slowly remodeled. This data supports a strategy to produce human textiles from CAM yarn for regenerative medicine applications where a scaffold with low inflammation and long-term mechanical properties are critical.
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Affiliation(s)
- Laure Magnan
- Univ. Bordeaux, INSERM, BIOTIS, UMR1026, F-33000, Bordeaux, France
| | - Fabien Kawecki
- Univ. Bordeaux, INSERM, BIOTIS, UMR1026, F-33000, Bordeaux, France
| | - Gaëlle Labrunie
- Univ. Bordeaux, INSERM, BIOTIS, UMR1026, F-33000, Bordeaux, France
| | - Maude Gluais
- Univ. Bordeaux, INSERM, BIOTIS, UMR1026, F-33000, Bordeaux, France
| | - Julien Izotte
- Animal Facility A2, University of Bordeaux, F-33076, Bordeaux, France
| | - Sébastien Marais
- UMS 3420 CNRS, US4 INSERM, Bordeaux Imaging Center, University of Bordeaux, F-33000, Bordeaux, France
| | - Marie-Pierre Foulc
- Rescoll Société de Recherche, 8 Allée Geoffroy Saint-Hilaire, CS 30021, F-33615, Pessac, France
| | - Mickaël Lafourcade
- Rescoll Société de Recherche, 8 Allée Geoffroy Saint-Hilaire, CS 30021, F-33615, Pessac, France
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Electrospinning of small diameter vascular grafts with preferential fiber directions and comparison of their mechanical behavior with native rat aortas. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 124:112085. [PMID: 33947575 DOI: 10.1016/j.msec.2021.112085] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 11/21/2022]
Abstract
Conventional electrospun small diameter vascular grafts have a random fiber orientation. In order to achieve mechanical characteristics similar to a native blood vessel, a controllable fiber orientation is of interest. In this study the electrospinning jet was directly controlled by means of an auxiliary, changeable electrostatic field, so that the fibers could be deposited in adjustable orientations. Prostheses with circumferentially, axially, fenestrated and randomly aligned fibers were electrospun on Ø2mm mandrels out of a thermoplastic polyurethane (PUR) and a polylactid acid (PLLA). The impact of the materials and the various preferential fiber orientations on the resulting biomechanics was investigated and compared with that of the native rat aorta in quasistatic and dynamic hoop tensile tests. The test protocol included 3000 dynamic loading cycles in the physiological blood pressure range and ended with a quasistatic tensile test. Any orientation of the fibers in a particular direction resulted in a significant reduction in scaffold porosity for both materials. The standard randomly oriented PUR grafts showed the highest compliance of 29.7 ± 5.5 [%/100 mmHg] and were thus closest to the compliance of the rat aortas, which was 37.2 ± 6.5 [%/100 mmHg]. The maximum tensile force was increased at least 6 times compared to randomly spun grafts by orienting the fibers in the circumferential direction. During the 3000 loading cycles, creeping of the native rat aorta was below 1% whereas the electrospun grafts showed creeping up to 2.4 ± 1.2%. Although the preferred fiber orientations were only partially visible in the scanning electron micrographs, the mechanical effects were evident. The investigations suggest a multi-layer wall structure of the vascular prosthesis, since none of the preferred fiber directions and the materials used could imitate the typical j-shaped mechanical characteristics of the rat aorta.
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Abstract
Tissue engineering is one of the most promising scientific breakthroughs of the late 20th century. Its objective is to produce in vitro tissues or organs to repair and replace damaged ones using various techniques, biomaterials, and cells. Tissue engineering emerged to substitute the use of native autologous tissues, whose quantities are sometimes insufficient to correct the most severe pathologies. Indeed, the patient’s health status, regulations, or fibrotic scars at the site of the initial biopsy limit their availability, especially to treat recurrence. This new technology relies on the use of biomaterials to create scaffolds on which the patient’s cells can be seeded. This review focuses on the reconstruction, by tissue engineering, of two types of tissue with tubular structures: vascular and urological grafts. The emphasis is on self-assembly methods which allow the production of tissue/organ substitute without the use of exogenous material, with the patient’s cells producing their own scaffold. These continuously improved techniques, which allow rapid graft integration without immune rejection in the treatment of severely burned patients, give hope that similar results will be observed in the vascular and urological fields.
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40
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Camasão DB, Mantovani D. The mechanical characterization of blood vessels and their substitutes in the continuous quest for physiological-relevant performances. A critical review. Mater Today Bio 2021; 10:100106. [PMID: 33889837 PMCID: PMC8050780 DOI: 10.1016/j.mtbio.2021.100106] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/07/2021] [Accepted: 02/27/2021] [Indexed: 11/29/2022] Open
Abstract
During the last 50 years, novel biomaterials and tissue engineering techniques have been investigated to produce alternative vascular substitutes that recapitulate the unique elastic mechanical features of blood vessels. A large variation in mechanical characterization, including the test type, protocol, and data analysis, is present in literature which complicates the comparison among studies and prevents the blooming and the advancement of this field. In addition, a limited mechanical assessment of the substitute for the intended application is often provided. In this light, this review presents the mechanical environment of blood vessels, discusses their mechanical behavior responsible for the suited blood flow into the body (non-linearity, anisotropy, hysteresis, and compliance), and compares the mechanical properties reported in literature (obtained with compression, tensile, stress-relaxation, creep, dynamic mechanical analysis, burst pressure, and dynamic compliance tests). This perspective highlights that the mechanical properties extracted through conventional tests are not always suitable indicators of the mechanical performance during the working life of a vascular substitute. The available tests can be then strategically used at different stages of the substitute development, prioritizing the simplicity of the method at early stages, and the physiological pertinence at later stages, following as much as possible ISO standards in the field. A consistent mechanical characterization focused on the behavior to which they will be subdued during real life is one key and missing element in the quest for physiological-like mechanical performance of vascular substitutes.
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Affiliation(s)
- D B Camasão
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met-Materials Engineering, Research Center of CHU de Québec, Division of Regenerative Medicine, Laval University, Québec, QC, G1V 0A6, Canada
| | - D Mantovani
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met-Materials Engineering, Research Center of CHU de Québec, Division of Regenerative Medicine, Laval University, Québec, QC, G1V 0A6, Canada
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41
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Williamson PN, Docherty PD, Yazdi SG, Khanafer A, Kabaliuk N, Jermy M. PIV Analysis of Haemodynamics Distal to the Frozen Elephant Trunk Stent Surrogate. Cardiovasc Eng Technol 2021; 12:373-386. [PMID: 33675018 DOI: 10.1007/s13239-021-00521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The Frozen Elephant Trunk (FET) stent is a hybrid endovascular device that may be implemented in the event of an aneurysm or aortic dissection of the aortic arch or superior descending aorta. A Type 1B endoleak can lead to intrasaccular flow during systole and has been identified as a known failure of the FET stent graft. The purpose was to develop in-vitro modelling techniques to enable the investigation of the known failure. METHODS A silicone aortic phantom and 3D printed surrogate stent graft were manufactured to investigate the haemodynamics of a Type 1B endoleak. Physiological pulsatile flow dynamics distal to the surrogate stent graft were investigated in-vitro using Particle Image Velocimetry (PIV). RESULTS PIV captured recirculation zones and an endoleak distal to the surrogate stent graft. The endoleak was developed at the peak of systole and sustained until the onset of diastole. The endoleak was asymmetric, indicating a potential variation in the phantom artery wall thickness or stent alignment. Recirculation was identified on the posterior dorsal line during late systole. CONCLUSIONS The identification of the Type 1B endoleak proved that in-vitro modelling can be used to investigate complex compliance changes and wall motions. The recirculation may indicate the potential for long term intimal layer inflammatory issues such as atherosclerosis. These results may aid future remediation techniques or stent design. Further development of the methods used in this experiment may assist with the future testing of stents prior to animal or human trial.
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Affiliation(s)
- Petra N Williamson
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
| | - Paul D Docherty
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand. .,Institute of Technical Medicine, Furtwangen University, Campus Villingen-Schwenningen, Jakob-Kienzle Strasse 17, 78054, Villingen-Schwenningen, Germany.
| | - Sina G Yazdi
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
| | - Adib Khanafer
- Vascular, Endovascular & Renal Transplant Unit, Christchurch Hospital, Canterbury District Health Board, Riccarton Avenue, Christchurch, 8053, New Zealand.,Christchurch School of Medicine, University of Otago, Dunedin, New Zealand
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
| | - Mark Jermy
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
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42
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Rosalia L, Ozturk C, Van Story D, Horvath MA, Roche ET. Object‐Oriented Lumped‐Parameter Modeling of the Cardiovascular System for Physiological and Pathophysiological Conditions. ADVANCED THEORY AND SIMULATIONS 2021. [DOI: 10.1002/adts.202000216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Luca Rosalia
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
- Harvard‐MIT Program in Health Sciences and Technology Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - Caglar Ozturk
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - David Van Story
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - Markus A. Horvath
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
- Harvard‐MIT Program in Health Sciences and Technology Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - Ellen T. Roche
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
- Harvard‐MIT Program in Health Sciences and Technology Massachusetts Institute of Technology Cambridge MA 02139 USA
- Department of Mechanical Engineering Massachusetts Institute of Technology Cambridge MA 02139 USA
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43
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Hu Q, Shen Z, Zhang H, Liu S, Feng R, Feng J, Ramalingam M. Designed and fabrication of triple-layered vascular scaffold with microchannels. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2021; 32:714-734. [PMID: 33332231 DOI: 10.1080/09205063.2020.1864083] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Currently, one of the best preparation strategies for the triple-layered vascular scaffold is to imitate the three-layer structure of natural blood vessels to achieve the biofunctional characteristics of vascular transplantation. Here, we developed a combinatorial method to fabricate triple-layered vascular scaffold (TVS) by using electrospinning and coaxial 3 D printing. First, Polycaprolactone-collagen (PCL-Col) was applied to prepared the inner layer of TVS by electrospinning. Second, egg white/sodium alginate (EW/SA) blend hydrogel was extruded to form hollow filaments by coaxial 3 D printing and crosslinking mechanism, which enwound around the surface of the inner layer in a circumferential direction as the intermediate layer of TVS. Finally, electrospun PCL-Col nanofibers were wrapped on the surface of hydrogel layer as the outer layer of TVS. The morphological characterization and mechanical strength of the fabricated TVS were measured. Compared with natural blood vessels, results shown that ultimate tensile stress (UTS), strain to failure (STF), the estimated burst strength and the suture retention strength (SRS) of TVS were superior. Also, the fabricated TVS exhibits good hydrophilicity and excellent flexibility. Moreover, the biocompatibility of TVS was investigated through human umbilical vein endothelial cells (HUVECs), the results demonstrated that cells can successfully attach the surface of graft and maintain high viability. In summary, all of results demonstrated that this method could fabricate a novel triple-layered vascular scaffold, possessing appropriate mechanical properties and good biological properties, which has the potential to be used in tissue engineered vascular grafts applications.
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Affiliation(s)
- Qingxi Hu
- Rapid Manufacturing Engineering Center, Mechatronic Engineering and Automation of Shanghai University, Shanghai, China.,Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China
| | - Zhipeng Shen
- Rapid Manufacturing Engineering Center, Mechatronic Engineering and Automation of Shanghai University, Shanghai, China
| | - Haiguang Zhang
- Rapid Manufacturing Engineering Center, Mechatronic Engineering and Automation of Shanghai University, Shanghai, China.,Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China
| | - Suihong Liu
- Rapid Manufacturing Engineering Center, Mechatronic Engineering and Automation of Shanghai University, Shanghai, China
| | - Rui Feng
- Department of Vascular Surgery, Changhai Hospital, Shanghai, China
| | - Jiaxuan Feng
- Department of Vascular Surgery, Changhai Hospital, Shanghai, China
| | - Murugan Ramalingam
- Biomaterials and Organ Engineering Group, Centre for Biomaterials, Cellular and Molecular Theranostics, School of Mechanical Engineering, Vellore Institute of Technology, Vellore, India
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44
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Zhuravleva II, Liashenko MM, Shadanov AA, Sirota DA, Cherniavskiĭ AM. [Quo vadimus? Fundamental problems of developing hybrid prostheses of thoracic aorta]. ANGIOLOGIIA I SOSUDISTAIA KHIRURGIIA = ANGIOLOGY AND VASCULAR SURGERY 2021; 27:103-112. [PMID: 35050254 DOI: 10.33529/angio2021412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article is a review briefly characterizing the state of the art of hybrid surgery of the thoracic aorta using the frozen elephant trunk technique worldwide and in Russia, also discussing unsolved problems of fundamental science, being key issues in creation of new models of hybrid prostheses of the thoracic aorta. The main attention is paid to the problem of radial stiffness of the stent-graft portion of the prosthesis. Performed is a detailed analysis of the factors influencing this characteristic of the sent graft: shape, size and number of cells of the stent element, thickness of the nitinol wire it is made of, method of edge connection, nitinol properties depending on the alloy grade and methods of thermoforming. It is shown that excessive stiffness leads to the development of d-SINE syndrome. This is followed by discussing the problem of optimal stiffness of stent grafts, based on the design of stent graft elements and elastic properties of the wall of the true channel of a dissecting aortic aneurysm. Also proposed is an approach to solving the problem of d-SINE, consisting in creation of conical stent grafts and/or a gradual decrease of radial stiffness of stent elements in the direction of the distal portion. Comprehensively addressed are disadvantages of the graft portion of the prosthesis, in 95% of items made of polyethylene terephthalate fiber: susceptibility to degradation associated with manufacturing defects and intraoperative microdamages, abrasive effect in the zone of contact with stent elements, partial postoperative hydrolysis and an inflammatory reaction to a foreign body, often being clinically pronounced. Also touched upon are certain aspects of creating hermetic coatings of the graft portion, with the use of vancomycin possessing low cytotoxicity as part of an antibacterial component being promising. As a whole, it is demonstrated that advances in creating a novel generation of hybrid prostheses should be associated with new approaches and materials, to be obtained at the junction of medicine and fundamental sciences.
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Affiliation(s)
- I Iu Zhuravleva
- Department of Aorta and Coronary Arteries Surgery, Laboratory of Bioprosthetics, National Medical Research Centre named after Academician E.N. Meshalkin, RF Ministry of Public Health, Novosibirsk, Russia
| | - M M Liashenko
- Department of Aorta and Coronary Arteries Surgery, Laboratory of Bioprosthetics, National Medical Research Centre named after Academician E.N. Meshalkin, RF Ministry of Public Health, Novosibirsk, Russia
| | - A A Shadanov
- Department of Aorta and Coronary Arteries Surgery, Laboratory of Bioprosthetics, National Medical Research Centre named after Academician E.N. Meshalkin, RF Ministry of Public Health, Novosibirsk, Russia
| | - D A Sirota
- Department of Aorta and Coronary Arteries Surgery, Laboratory of Bioprosthetics, National Medical Research Centre named after Academician E.N. Meshalkin, RF Ministry of Public Health, Novosibirsk, Russia
| | - A M Cherniavskiĭ
- Department of Aorta and Coronary Arteries Surgery, Laboratory of Bioprosthetics, National Medical Research Centre named after Academician E.N. Meshalkin, RF Ministry of Public Health, Novosibirsk, Russia
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45
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Mallis P, Kostakis A, Stavropoulos-Giokas C, Michalopoulos E. Future Perspectives in Small-Diameter Vascular Graft Engineering. Bioengineering (Basel) 2020; 7:E160. [PMID: 33321830 PMCID: PMC7763104 DOI: 10.3390/bioengineering7040160] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
The increased demands of small-diameter vascular grafts (SDVGs) globally has forced the scientific society to explore alternative strategies utilizing the tissue engineering approaches. Cardiovascular disease (CVD) comprises one of the most lethal groups of non-communicable disorders worldwide. It has been estimated that in Europe, the healthcare cost for the administration of CVD is more than 169 billion €. Common manifestations involve the narrowing or occlusion of blood vessels. The replacement of damaged vessels with autologous grafts represents one of the applied therapeutic approaches in CVD. However, significant drawbacks are accompanying the above procedure; therefore, the exploration of alternative vessel sources must be performed. Engineered SDVGs can be produced through the utilization of non-degradable/degradable and naturally derived materials. Decellularized vessels represent also an alternative valuable source for the development of SDVGs. In this review, a great number of SDVG engineering approaches will be highlighted. Importantly, the state-of-the-art methodologies, which are currently employed, will be comprehensively presented. A discussion summarizing the key marks and the future perspectives of SDVG engineering will be included in this review. Taking into consideration the increased number of patients with CVD, SDVG engineering may assist significantly in cardiovascular reconstructive surgery and, therefore, the overall improvement of patients' life.
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Affiliation(s)
- Panagiotis Mallis
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| | - Alkiviadis Kostakis
- Center of Experimental Surgery and Translational Research, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece;
| | - Catherine Stavropoulos-Giokas
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| | - Efstathios Michalopoulos
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
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46
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Kimicata M, Swamykumar P, Fisher JP. Extracellular Matrix for Small-Diameter Vascular Grafts. Tissue Eng Part A 2020; 26:1388-1401. [PMID: 33231135 PMCID: PMC7759287 DOI: 10.1089/ten.tea.2020.0201] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/11/2020] [Indexed: 01/15/2023] Open
Abstract
To treat coronary heart disease, coronary artery bypass grafts are used to divert blood flow around blockages in the coronary arteries. Autologous grafts are the gold standard of care, but they are characterized by their lack of availability, low quality, and high failure rates. Alternatively, tissue-engineered small-diameter vascular grafts made from synthetic or natural polymers have not demonstrated adequate results to replace autologous grafts; synthetic grafts result in a loss of patency due to thrombosis and intimal hyperplasia, whereas scaffolds from natural polymers are generally unable to support the physiological conditions. Extracellular matrix (ECM) from a variety of sources, including cell-derived, 2D, and cannular tissues, has become an increasingly useful tool for this application. The current review examines the ECM-based methods that have recently been investigated in the field and comments on their viability for clinical applications.
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Affiliation(s)
- Megan Kimicata
- Department of Materials Science and Engineering, University of Maryland, College Park, Maryland, USA
- Center for Engineering Complex Tissues, and University of Maryland, College Park, Maryland, USA
| | - Prateek Swamykumar
- Center for Engineering Complex Tissues, and University of Maryland, College Park, Maryland, USA
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - John P. Fisher
- Center for Engineering Complex Tissues, and University of Maryland, College Park, Maryland, USA
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
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47
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Zbinden JC, Blum KM, Berman AG, Ramachandra AB, Szafron JM, Kerr KE, Anderson JL, Sangha GS, Earl CC, Nigh NR, Mirhaidari GJM, Reinhardt JW, Chang Y, Yi T, Smalley R, Gabriele PD, Harris JJ, Humphrey JD, Goergen CJ, Breuer CK. Effects of Braiding Parameters on Tissue Engineered Vascular Graft Development. Adv Healthc Mater 2020; 9:e2001093. [PMID: 33063452 DOI: 10.1002/adhm.202001093] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/17/2020] [Indexed: 01/06/2023]
Abstract
Tissue engineered vascular grafts (TEVGs) using scaffolds fabricated from braided poly(glycolic acid) (PGA) fibers coated with poly(glycerol sebacate) (PGS) are developed. The approach relies on in vivo tissue engineering by which neotissue forms solely within the body after a scaffold has been implanted. Herein, the impact of altering scaffold braid design and scaffold coating on neotissue formation is investigated. Several combinations of braiding parameters are manufactured and evaluated in a Beige mouse model in the infrarenal abdominal aorta. Animals are followed with 4D ultrasound analysis, and 12 week explanted vessels are evaluated for biaxial mechanical properties as well as histological composition. Results show that scaffold parameters (i.e., braiding angle, braiding density, and presence of a PGS coating) have interdependent effects on the resulting graft performance, namely, alteration of these parameters influences levels of inflammation, extracellular matrix production, graft dilation, neovessel distensibility, and overall survival. Coupling carefully designed in vivo experimentation with regression analysis, critical relationships between the scaffold design and the resulting neotissue that enable induction of favorable cellular and extracellular composition in a controlled manner are uncovered. Such an approach provides a potential for fabricating scaffolds with a broad range of features and the potential to manufacture optimized TEVGs.
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Affiliation(s)
- Jacob C. Zbinden
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
| | - Kevin M. Blum
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
| | - Alycia G. Berman
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Abhay B. Ramachandra
- Department of Biomedical Engineering, Yale University 55 Prospect Street New Haven CT 06520 USA
| | - Jason M. Szafron
- Department of Biomedical Engineering, Yale University 55 Prospect Street New Haven CT 06520 USA
| | - Katherine E. Kerr
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Jennifer L. Anderson
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Gurneet S. Sangha
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Conner C. Earl
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Noah R. Nigh
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Gabriel J. M. Mirhaidari
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
| | - James W. Reinhardt
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
| | - Yu‐Chun Chang
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
| | - Tai Yi
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
| | - Ryan Smalley
- Secant Group, LLC 551 East Church Ave Telford PA 18969 USA
| | | | | | - Jay D. Humphrey
- Department of Biomedical Engineering, Yale University 55 Prospect Street New Haven CT 06520 USA
| | - Craig J. Goergen
- Weldon School of Biomedical Engineering, Purdue University 206 S Martin Jischke Drive West Lafayette IN 47907 USA
| | - Christopher K. Breuer
- Nationwide Children's Hospital, Abagail Wexner Research Institute 575 Children's Crossroad Columbus OH 43215 USA
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48
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Legerer C, Stevens M, Vazquez GM, Müller T, Ferrington L. An experimental evaluation of a concept to improve conventional aortic prostheses. J Biomech 2020; 112:110010. [PMID: 32977296 DOI: 10.1016/j.jbiomech.2020.110010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/31/2020] [Accepted: 08/18/2020] [Indexed: 11/18/2022]
Abstract
Conventionally used textile prosthesis for traditional open surgical repair (OSR) of aortic aneurysms have a lower compliance than the native aortic tissue. Graft placements lead to an acute drop in compliance which effects cardiovascular risk and the development of graft related complications. A custom-made spring casing was applied to a Dacron graft segment under physiological pressure conditions within a five-element biventricular mock circulation loop, to investigate experimentally a concept to improve the compliance of a conventional aortic prosthesis by changing the transverse graft cross-section. Two different prosthesis locations, proximal and distal of compliant silicone tubing were used to study uniaxial graft compression with an elastic device. To characterise the devices' performance by means of pulse pressure (PP), diastolic pressure (Pdia) and pulse wave velocity(PWV), fluid pressures and flow were recorded. In a proximal graft setting (ascending aorta repair) elastic uniaxial compression with a custom-made spring casing (2 cm width) could significantly reduce PP by 10-14% (p < .001) and slowed PWV from 6.7 to 5.2 m/s (22%, p = .002). Applied to a graft in a distal position, the spring casing demonstrated less impact on PP (2-10%), but significantly reduced PWV in this mock aorta segment from 13.7 to 5.5 m/s (60%, p = .004). In conclusion, a newly conceptualised spring casing applied to the external wall of synthetic aortic grafts can reduce PP and slow PWV. By restoring elastic aortic recoil in stiff textile aortic prostheses, the presented concept is a potential solution to improve long-term aortic prosthesis related complications.
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Affiliation(s)
- C Legerer
- Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - M Stevens
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - G M Vazquez
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - T Müller
- Medical University of Graz, 8036 Graz, Austria
| | - L Ferrington
- Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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49
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Sthijns MMJPE, Jetten MJ, Mohammed SG, Claessen SMH, de Vries RHW, Stell A, de Bont DFA, Engelse MA, Mumcuoglu D, van Blitterswijk CA, Dankers PYW, de Koning EJP, van Apeldoorn AA, LaPointe VLS. Oxidative stress in pancreatic alpha and beta cells as a selection criterion for biocompatible biomaterials. Biomaterials 2020; 267:120449. [PMID: 33129188 DOI: 10.1016/j.biomaterials.2020.120449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/12/2022]
Abstract
The clinical success rate of islet transplantation, namely independence from insulin injections, is limited by factors that lead to graft failure, including inflammation, acute ischemia, acute phase response, and insufficient vascularization. The ischemia and insufficient vascularization both lead to high levels of oxidative stress, which are further aggravated by islet encapsulation, inflammation, and undesirable cell-biomaterial interactions. To identify biomaterials that would not further increase damaging oxidative stress levels and that are also suitable for manufacturing a beta cell encapsulation device, we studied five clinically approved polymers for their effect on oxidative stress and islet (alpha and beta cell) function. We found that 300 poly(ethylene oxide terephthalate) 55/poly(butylene terephthalate) 45 (PEOT/PBT300) was more resistant to breakage and more elastic than other biomaterials, which is important for its immunoprotective function. In addition, it did not induce oxidative stress or reduce viability in the MIN6 beta cell line, and even promoted protective endogenous antioxidant expression over 7 days. Importantly, PEOT/PBT300 is one of the biomaterials we studied that did not interfere with insulin secretion in human islets.
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Affiliation(s)
- Mireille M J P E Sthijns
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Marlon J Jetten
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Sami G Mohammed
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Sandra M H Claessen
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Rick H W de Vries
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Adam Stell
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Denise F A de Bont
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Marten A Engelse
- Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Didem Mumcuoglu
- Department of Biomedical Engineering, and Institute for Complex Molecular Systems, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, the Netherlands
| | - Clemens A van Blitterswijk
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Patricia Y W Dankers
- Department of Biomedical Engineering, and Institute for Complex Molecular Systems, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, the Netherlands
| | - Eelco J P de Koning
- Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands; Hubrecht Institute, Uppsalalaan 8, 3584 CT, Utrecht, the Netherlands
| | - Aart A van Apeldoorn
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Vanessa L S LaPointe
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
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Vento V, Lejay A, Kuntz S, Ancetti S, Heim F, Chakfé N, Gargiulo M. Current status on aortic endografts. THE JOURNAL OF CARDIOVASCULAR SURGERY 2020; 61:544-554. [PMID: 32964901 DOI: 10.23736/s0021-9509.20.11614-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Endovascular treatment has become widespread to treat aneurysmal disease, especially located in the aorta. The modern era of abdominal aortic aneurysm repair started between 1986 and 1991, and in the last 30 years, Endovascular Treatment for abdominal aortic aneurysms evolved both due to the development of new materials and devices and the increasing appeal and effectiveness of the endovascular therapy itself. Vascular surgeons are using nowadays different solutions of Endovascular Treatment to treat all the expressions of aortic pathology (aneurysms, dissections and trauma) both in the acute and elective setting. Despite its use in every location of the aorta (the ascending aorta, the aortic arch, the thoracic aorta, thoraco-abdominal aorta, pararenal, iuxtarenal and infrarenal aortic aneurysms and iliac aneurysms), its safety and efficiency, endovascular treatment for aortic aneurysms presents some drawbacks: despite a lower short-term morbi-mortality, reinterventions and long-term patency are higher compared to open repair. In this review, we detail the most used types of endografts according to location, their performances and durability for each device. We conclude by discussing options to overcome ET limitations. Therefore, an obvious question arises: what we need in the future? What can the technological progress gives to physicians to further improve this new way of treating aorta?
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Affiliation(s)
- Vincenzo Vento
- Unit of Vascular Surgery, Department of Experimental Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy.,Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Anne Lejay
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Salomé Kuntz
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Stefano Ancetti
- Unit of Vascular Surgery, Department of Experimental Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Frédéric Heim
- Laboratory of Physics and Textile Mechanics, University of Upper Alsace, Mulhouse, France
| | - Nabil Chakfé
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Mauro Gargiulo
- Unit of Vascular Surgery, Department of Experimental Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy -
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