García-Honduvilla Natalio, Domínguez Belén, Pascual Gemma, Escudero Cristina, Minguela Francisco, Bellón Juan Manuel, Buján Julia
Department of Surgery, Faculty of Medicine, University of Alcalá, Alcalá de Henares, and Networking Research Center on Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
Ann Vasc Surg. 2008 Mar;22(2):255-65. doi: 10.1016/j.avsg.2007.12.007.
The search for vessel substitutes to replace small-/medium-caliber vessels is an ongoing concern for vascular surgeons. Engineered vessels were designed for use as arterial equivalents and assessed in an in vivo model in dog. Three study groups were established: clinical expanded polytetrafluoroethylene (ePTFE; control, n = 24), ePTFE seeding with endothelial cells (EC graft, n = 12), and ePTFE with a fibroblast matrix seeded with EC (FM+EC graft, n = 12). Grafts were subjected to a custom-designed femoral ex vivo circuit and implanted in the carotid artery for 60 days. The viability of the prosthetic grafts was evaluated. The ex vivo circuit revealed that the presence of a fibroblast matrix induced over double the cell retention compared to EC grafts. A significant reduction in platelet adhesion in EC grafts was observed. After their in vivo implantation, the engineered vessels were more efficient at avoiding occlusion than the prosthetic grafts. The FM+EC grafts induced more endothelialization than those seeded with ECs alone. Intimal hyperplasia response was reduced in the EC substitutes. Significant differences in apoptotic cells emerged between the EC and control ePTFE grafts. In conclusion, engineered vessels showed improved initial patency over ePTFE grafts. The EC graft was best at combating restenosis, a good indicator of the long-term efficiency of the graft.
寻找可替代中小口径血管的血管替代品一直是血管外科医生关注的问题。工程血管被设计用作动脉替代物，并在犬体内模型中进行评估。设立了三个研究组：临床用膨体聚四氟乙烯（ePTFE；对照组，n = 24）、接种内皮细胞的ePTFE（EC移植物，n = 12）以及带有接种了内皮细胞的成纤维细胞基质的ePTFE（FM + EC移植物，n = 12）。将移植物置于定制设计的股动脉体外循环装置中，并植入颈动脉60天。评估人工血管移植物的存活情况。体外循环显示，与EC移植物相比，成纤维细胞基质的存在使细胞保留率提高了一倍多。观察到EC移植物中血小板黏附显著减少。在体内植入后，工程血管在避免堵塞方面比人工血管移植物更有效。FM + EC移植物诱导的内皮化比仅接种内皮细胞的移植物更多。EC替代物中的内膜增生反应有所减轻。EC移植物与对照ePTFE移植物之间凋亡细胞出现显著差异。总之，工程血管在初始通畅性方面优于ePTFE移植物。EC移植物在对抗再狭窄方面效果最佳，而再狭窄是移植物长期有效性的一个良好指标。
