Rocco Kevin A, Maxfield Mark W, Best Cameron A, Dean Ethan W, Breuer Christopher K
1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut.
Tissue Eng Part B Rev. 2014 Dec;20(6):628-40. doi: 10.1089/ten.TEB.2014.0123. Epub 2014 Jun 18.
There is great clinical demand for synthetic vascular grafts with improved long-term efficacy. The ideal vascular conduit is easily implanted, nonthrombogenic, biocompatible, resists aneurysmal dilatation, and ultimately degrades or is assimilated as the patient remodels the graft into tissue resembling native vessel. The field of vascular tissue engineering offers an opportunity to design the ideal synthetic graft, and researchers have evaluated a variety of methods and materials for use in graft construction. Electrospinning is one method that has received considerable attention within tissue engineering for constructing so-called tissue scaffolds. Tissue scaffolds are temporary, porous structures which are commonly composed of bioresorbable polymers that promote native tissue ingrowth and have degradation kinetics compatible with a patient's rate of extracellular matrix production in order to successfully transit from synthetic conduits into neovessels. In this review, we summarize the history of tissue-engineered vascular grafts (TEVG), focusing on scaffolds generated by the electrospinning process, and discuss in vivo applications. We review the materials commonly employed in this approach and the preliminary results after implantation in animal models in order to gauge clinical viability of the electrospinning process for TEVG construction. Scientists have studied electrospinning technology for decades, but only recently has it been orthotopically evaluated in animal models such as TEVG. Advantages of electrospun TEVG include ease of construction, favorable cellular interactions, control of scaffold features such as fiber diameter and pore size, and the ability to choose from a variety of polymers possessing a range of mechanical and chemical properties and degradation kinetics. Given its advantages, electrospinning technology merits investigation for use in TEVG, but an emphasis on long-term in vivo evaluation is required before its role in clinical vascular tissue engineering can be realized.
对于具有更高长期疗效的合成血管移植物存在巨大的临床需求。理想的血管导管应易于植入、无血栓形成、具有生物相容性、能抵抗动脉瘤样扩张,并最终在患者将移植物重塑为类似天然血管的组织时降解或被吸收。血管组织工程领域为设计理想的合成移植物提供了契机,研究人员已经评估了多种用于移植物构建的方法和材料。静电纺丝是一种在组织工程中备受关注的构建所谓组织支架的方法。组织支架是临时的多孔结构,通常由可生物吸收的聚合物组成,这些聚合物可促进天然组织向内生长,并且具有与患者细胞外基质产生速率相匹配的降解动力学,以便成功地从合成导管转变为新血管。在本综述中,我们总结了组织工程血管移植物(TEVG)的历史,重点关注通过静电纺丝工艺生成的支架,并讨论其体内应用。我们回顾了该方法中常用的材料以及在动物模型中植入后的初步结果,以评估静电纺丝工艺用于构建TEVG的临床可行性。科学家们已经研究静电纺丝技术数十年了,但直到最近才在诸如TEVG等动物模型中进行原位评估。静电纺丝TEVG的优点包括易于构建、良好的细胞相互作用、对支架特征(如纤维直径和孔径)的控制,以及能够从具有一系列机械和化学性质以及降解动力学的多种聚合物中进行选择。鉴于其优点,静电纺丝技术值得在TEVG中进行研究,但在其在临床血管组织工程中的作用得以实现之前,需要重点进行长期的体内评估。