Valencia Rivero Karen Tatiana, Jaramillo Escobar Juliana, Galvis Forero Sergio David, Miranda Saldaña Maria Clara, López Panqueva Rocío Del Pilar, Sandoval Reyes Néstor Fernando, Briceño Triana Juan Carlos
a Department of Biomedical Engineering , Universidad de los Andes , Bogotá , Colombia.
b ANESTCOL SAS , Bogotá , Colombia.
J Invest Surg. 2018 Jun;31(3):192-200. doi: 10.1080/08941939.2017.1303100. Epub 2017 Apr 17.
The purpose of this study was to evaluate a suitable animal model for the in vivo evaluation of patency and vascular tissue regeneration in small intestinal submucosa (SIS) vascular grafts for hemodialysis access. First, a 4-mm U-shaped SIS vascular graft was implanted between the internal carotid artery (CA) and the external jugular vein (JV) in five sheep and six swine. The U-shape grafts remained functional for 53 ± 4 days in sheep and 32 ± 2 days in swine. The sheep model presented exaggerated inflammation, so the swine model was selected for the in vivo study. Based on these initial results, a 4-mm C-shape SIS vascular graft with SIS circumferential reinforcement was developed to mechanically improve the vascular graft and manage complications identified during surgery in both sheep and swine. The C-shape vascular graft was implanted in a swine model (n = 3) between the CA and JV. GORE-TEX® vascular grafts were used as controls in the contralateral side of the neck. C-shape grafts remained patent for 47 ± 4 days, whereas the GORE-TEX® grafts were patent for 30 ± 15 days. The C-shape vascular graft was easier to handle during surgery, and its circumferential reinforcement improved in vivo patency, avoiding kinks in the graft after implantation. Histological results showed neovascularization and some regeneration with the alignment of endothelial cells in the vascular wall of the grafts. The model developed may be helpful in other research involving in vivo studies of vascular grafts for hemodialysis access.
本研究的目的是评估一种合适的动物模型，用于体内评估用于血液透析通路的小肠黏膜下层（SIS）血管移植物的通畅性和血管组织再生。首先，在五只绵羊和六头猪的颈内动脉（CA）和颈外静脉（JV）之间植入一个4毫米的U形SIS血管移植物。U形移植物在绵羊体内保持功能53±4天，在猪体内保持32±2天。绵羊模型出现了过度炎症，因此选择猪模型进行体内研究。基于这些初步结果，开发了一种带有SIS环向增强的4毫米C形SIS血管移植物，以机械方式改进血管移植物并处理在绵羊和猪手术过程中发现的并发症。将C形血管移植物植入猪模型（n = 3）的CA和JV之间。在颈部对侧使用GORE-TEX®血管移植物作为对照。C形移植物保持通畅47±4天，而GORE-TEX®移植物保持通畅30±15天。C形血管移植物在手术过程中更易于操作，其环向增强改善了体内通畅性，避免了植入后移植物出现扭结。组织学结果显示有新生血管形成以及一些再生，移植物血管壁内的内皮细胞排列整齐。所开发的模型可能有助于其他涉及用于血液透析通路的血管移植物体内研究的项目。
