Kawajiri Hidetake, Mizuno Takeshi, Moriwaki Takeshi, Iwai Ryosuke, Ishibashi-Ueda Hatsue, Yamanami Masashi, Kanda Keiichi, Yaku Hitoshi, Nakayama Yasuhide
Division of Medical Engineering and Materials, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, 565-8565, Japan,
J Artif Organs. 2015 Mar;18(1):48-54. doi: 10.1007/s10047-014-0796-7. Epub 2014 Oct 16.
The use of stent grafts for endovascular aortic repair has become an important treatment option for aortic aneurysms requiring surgery. This treatment has achieved excellent outcomes; however, problems like type 1 endoleaks and stent graft migration remain. Bio stent grafts (BSGs), which are self-expanding stents covered with connective tissue, were previously developed using "in-body tissue architecture" technology. We assessed their early adaptation to the aorta after transcatheter implantation in a beagle model. BSGs were prepared by subcutaneous embedding of acryl rods mounted with self-expanding nitinol stents in three beagles for 4 weeks (n = 3/dog). The BSGs were implanted as allografts into infrarenal abdominal aortas via the femoral artery of three other beagles. After 1 month of implantation, aortography revealed no stenosis or aneurysmal changes. The luminal surface of the BSGs was completely covered with neointimal tissue, including endothelialization, without any thrombus formation. The cover tissue could fuse the luminal surface of the native aorta with tight conjunctions even at both ends of the stents, resulting in complete impregnation of the strut into the reconstructed vascular wall, which is expected to prevent endoleaks and migration in clinical applications.
使用支架型人工血管进行血管腔内主动脉修复已成为需要手术治疗的主动脉瘤的重要治疗选择。这种治疗取得了优异的效果;然而,I型内漏和支架型人工血管移位等问题仍然存在。生物支架型人工血管(BSG)是覆盖有结缔组织的自膨式支架,此前利用“体内组织结构”技术研发而成。我们在比格犬模型中评估了经导管植入后它们对主动脉的早期适应性。通过将装有自膨式镍钛诺支架的丙烯酸棒皮下植入三只比格犬体内4周来制备BSG(每只犬n = 3)。将这些BSG作为同种异体移植物通过另外三只比格犬的股动脉植入肾下腹主动脉。植入1个月后,主动脉造影显示无狭窄或动脉瘤样改变。BSG的管腔表面完全被新生内膜组织覆盖,包括内皮化,且无任何血栓形成。覆盖组织能够通过紧密连接使天然主动脉的管腔表面融合,即使在支架的两端也是如此,从而使支柱完全融入重建的血管壁,这有望在临床应用中预防内漏和移位。