The long-term patency of small-diameter vascular grafts is still unsatisfactory. In contrast to native arteries, they are inelastic and lack active antithrombogenicity. To improve long-term patency, a new 4 mm internal diameter prosthesis was developed which is compliant and lined with functional endothelial cells (ENC). The wall of this prosthesis consists of a microporous polyurethane-siloxane copolymer reinforced with a polyester network. It displays compliance (13.2 x 10(-4) mmHg-1) comparable to native arteries, is nonkinkable (minimum radius of curvature = 5 mm), burst resistant, and easily suturable. Using a lining procedure, coverage of prostheses by ENC was in excess of 95%. The ENC populations were found to be highly pure (by factor VIII-related antigen, DilAcLDL uptake) and to produce about 0.3 ng prostacyclin per cm2. In vitro tests of shear stress resistance demonstrated that ENC monolayers on the new elastic prosthesis remain intact for 3 hr in physiologically pulsating culture medium (Vmax = 50 cm/sec). Lined prostheses implanted for 24 hours in mongrel dogs as an arteriovenous shunt demonstrated the antithrombogenicity of the cultured ENC. The results suggest that small-diameter vascular prostheses which are compliant, porous, and actively antithrombogenic are feasible.
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Arch Plast Surg
January 2025
Department of Plastic and Reconstructive Surgery, University Clinic Skopje, North Macedonia.
Microsurgical reconstruction constitutes a fundamental part of plastic and reconstructive surgery. It demands high dexterity and intricate technical skills. Its steep learning curve benefits from thorough training throughout residency, where using realistic simulation models in the appropriate sequence of complexity progression is essential in ensuring patient safety prior to progressing to a clinical setting.
View Article and Find Full Text PDFACS Appl Bio Mater
January 2025
Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China.
Chitosan is generally considered to be a procoagulant effect, which may cause adverse phenomena such as blood clotting when used in small-diameter vascular grafts. However, it also shows good biocompatibility and anti-inflammatory properties, which can facilitate vascular reconstruction. Therefore, it is significant to transition the effect of chitosan from coagulation promotion to antiplatelet while still harnessing its bioactivity.
View Article and Find Full Text PDFTissue Eng Regen Med
January 2025
College of Materials Science and Engineering, Hunan University, Changsha, 410072, People's Republic of China.
Background: Tissue engineering holds promise for vascular repair and regeneration by mimicking the extracellular matrix of blood vessels. However, achieving a functional and thick vascular wall with aligned fiber architecture by electrospinning remains a significant challenge.
Methods: A novel electrospinning setup was developed that utilizes an auxiliary electrode and a spring.
ACS Nano
January 2025
Shenzhen Key Laboratory of Smart Healthcare Engineering, Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, No. 1088 Xueyuan Road, Nanshan District, Shenzhen, Guangdong 518055, PR China.
Extracellular matrix (ECM)-based small-diameter vascular grafts (SDVGs, inner diameter (ID) < 6 mm) hold great promise for clinical applications. However, existing ECM-based SDVGs suffer from limited donor availability, complex purification, high cost, and insufficient mechanical properties. SDVGs with ECM-like structure and function, and good mechanical properties were rapidly prepared by optimizing common materials and preparation, which can improve their clinical prospects.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
December 2024
Cardiac Surgery Department, Sanatorio Italiano, Asunción, Paraguay.
Coronary artery bypass graft (CABG) surgery remains the gold standard in the treatment of complex coronary artery disease. Saphenous vein grafts (SVG) are commonly used for the non-left anterior descending artery. However, SVG failure rates in CABG surgery have been reported to be as high as 30% at 1 year and ∼50% at 10 years.
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