Wenzhou Medical University, Wenzhou City, Zhejiang Province, China ; College of Medicine, Drexel University, Philadelphia, Pennsylvania, United States of America.
PLoS One. 2013 Aug 27;8(8):e73178. doi: 10.1371/journal.pone.0073178. eCollection 2013.
Despite progress in the design of advanced surgical techniques, stenosis recurs in a large percentage of vascular anastomosis. In this study, a novel heparin-poloxamer (HP) hydrogel was designed and its effects for improving the quality and safety of vascular anastomosis were studied. HP copolymer was synthesized and its structure was confirmed by Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance spectroscopy ((1)H-NMR). Hydrogels containing HP were prepared and their important characteristics related to the application in vascular anastomosis including gelation temperature, rheological behaviour and micromorphology were measured. Vascular anastomosis were performed on the right common carotid arteries of rabbits, and the in vivo efficiency and safety of HP hydrogel to achieve vascular anastomosis was verified and compared with Poloxamer 407 hydrogel and the conventional hand-sewn method using Doppler ultrasound, CT angiograms, scanning electron microscopy (SEM) and histological technique. Our results showed that HP copolymer displayed special gel-sol-gel phase transition behavior with increasing temperature from 5 to 60 °C. HP hydrogel prepared from 18 wt% HP solution had a porous sponge-like structure, with gelation temperature at approximately 38 °C and maximum elastic modulus at 10,000 Pa. In animal studies, imaging and histological examination of rabbit common jugular artery confirmed that HP hydrogel group had similar equivalent patency, flow and burst strength as Poloxamer 407 group. Moreover, HP hydrogel was superior to poloxamer 407 hydrogel and hand-sewn method for restoring the functions and epithelial structure of the broken vessel junctions after operation. By combining the advantages of heparin and poloxamer 407, HP hydrogel holds high promise for improving vascular anastomosis quality and safety.
尽管在先进的外科技术设计方面取得了进展，但血管吻合术仍有很大比例会出现狭窄。在这项研究中，设计了一种新型肝素-泊洛沙姆（HP）水凝胶，并研究了其改善血管吻合术质量和安全性的效果。合成了 HP 共聚物，并通过傅里叶变换红外光谱（FTIR）和核磁共振波谱（（1）H-NMR）确认了其结构。制备了含有 HP 的水凝胶，并测量了与血管吻合术应用相关的重要特性，包括胶凝温度、流变行为和微观形态。在兔子的右颈总动脉上进行血管吻合术，通过多普勒超声、CT 血管造影、扫描电子显微镜（SEM）和组织学技术验证和比较了 HP 水凝胶在实现血管吻合术中的体内效率和安全性，与泊洛沙姆 407 水凝胶和常规手工缝合方法进行了比较。我们的结果表明，HP 共聚物在温度从 5°C 升高到 60°C 时表现出特殊的凝胶-溶胶-凝胶相变行为。由 18wt% HP 溶液制备的 HP 水凝胶具有多孔海绵状结构，胶凝温度约为 38°C，最大弹性模量为 10000Pa。在动物研究中，对兔颈总动脉的成像和组织学检查证实，HP 水凝胶组与泊洛沙姆 407 组具有相似的等效通畅率、流量和爆裂强度。此外，HP 水凝胶在恢复术后破损血管连接处的功能和上皮结构方面优于泊洛沙姆 407 水凝胶和手工缝合方法。HP 水凝胶结合了肝素和泊洛沙姆 407 的优点，有望显著提高血管吻合术的质量和安全性。
