Chlupác J, Filová E, Bacáková L
Oddellení růstu a diferenciace bunecných populací, Fyziologický ústav, Akademie ved CR, v.v.i., Praha, Ceská republika.
Rozhl Chir. 2010 Jan;89(1):85-94.
Since more than 50 years, the gold standard in synthetic vascular prostheses has been represented by polyethylene terephtalate (PET, Dacron) and expanded polytetrafluoroethylene (ePTFE). These polymers perform well as sustitutes of large-caliber vessels, however, their long-term patencies are disappointing in small-caliber applications (< 6 mm). Thus, patient's own artery or vein remains the material of choice in coronary, crural or microvessel bypass surgery. Synthetic materials fail due to thrombosis and insufficient healing process that consists in highly incomplete endothelial cells coverage and intimal hyperplasia caused by compliance mismatch and hemodynamic imbalance. To find better small-caliber vascular graft, surgical techniques have been modified, novel biomaterials have been investigated and cell and tissue culture technologies have been adopted. Partly or fully tissue-engineered vascular grafts have been produced and experimentally and clinically evaluated with some promising result. The aim of this review is to briefly list currently used and examined vascular graft materials with special attention to cell/biomaterial ineractions, tissue engineering and authors' own experience.
五十多年来,合成血管假体的金标准一直是聚对苯二甲酸乙二酯(PET,涤纶)和膨体聚四氟乙烯(ePTFE)。这些聚合物作为大口径血管的替代品表现良好,然而,它们在小口径应用(<6mm)中的长期通畅性却令人失望。因此,患者自身的动脉或静脉仍然是冠状动脉、下肢或微血管搭桥手术的首选材料。合成材料失败是由于血栓形成和愈合过程不足,这包括高度不完全的内皮细胞覆盖以及由顺应性不匹配和血流动力学失衡引起的内膜增生。为了找到更好的小口径血管移植物,手术技术已被改进,新型生物材料已被研究,细胞和组织培养技术也已被采用。部分或完全组织工程化的血管移植物已经制备出来,并进行了实验和临床评估,取得了一些有前景的结果。这篇综述的目的是简要列出目前使用和研究的血管移植物材料,特别关注细胞/生物材料相互作用、组织工程以及作者自己的经验。