1 Department of Biomedical Engineering, Oregon Health & Science University , Portland, Oregon.
2 Department of Chemical Engineering, University of Waterloo , Waterloo, Ontario, Canada .
Tissue Eng Part C Methods. 2018 Aug;24(8):457-464. doi: 10.1089/ten.TEC.2018.0099.
While clinical vascular grafting uses an end-to-side surgical method, researchers primarily use end-to-end implant techniques in preclinical models. This may be due in part to the limitations of using small animal models in research. The work presented here provides support and evidence for the improvement of vascular graft implant techniques by demonstrating the successful implantation of experimental grafts into both large and small animal models. Specifically, models of aortoiliac baboon (Papio anubis) bypass and common carotid rabbit (Oryctolagus cuniculus) bypass were used to test vascular grafts for thrombosis and vascular healing after 1 month using an end-to-side anastomosis grafting procedure. Patency was evaluated with ultrasound or histological techniques, and neointimal growth was quantified with histology. In the development of this procedure for small animals, both an end-to-end/end-to-side and an end-to-side/end-to-side configuration were tested in rabbits. One hundred percent of rabbit implants (2/2) with an end-to-end/end-to-side configuration were patent at explant. However, with the end-to-side/end-to-side configuration, 66% (6/9) of rabbit implants and 93% (13/14) of baboon implants remained patent at 1 month, suggesting the importance of replicating the end-to-side method for testing vascular grafts for clinical use. This study describes feasible preclinical surgical procedures, which simulate clinical vascular bypass grafts even in small animals. Widespread implementation of these end-to-side surgical techniques in these or other animals should improve the quality of experimental, preclinical testing and ultimately increase the likelihood of translating new vascular graft technologies into clinical applications.
虽然临床血管移植采用端侧手术方法，但研究人员主要在临床前模型中使用端端植入技术。这可能部分归因于在研究中使用小动物模型的局限性。本文介绍的工作通过展示在大、小动物模型中成功植入实验性移植物，为改善血管移植物植入技术提供了支持和证据。具体来说，使用狒狒（Papio anubis）腹主动脉-髂动脉旁路和家兔（Oryctolagus cuniculus）颈总动脉旁路模型，采用端侧吻合移植术，在 1 个月后评估血栓形成和血管愈合情况。采用超声或组织学技术评估通畅性，用组织学方法定量测量新生内膜生长。在为小动物开发该程序的过程中，在兔中测试了端端/端侧和端侧/端侧两种配置。端端/端侧配置的兔植入物（2/2）100%通畅，在取出时没有闭塞。然而，对于端侧/端侧配置，66%（6/9）的兔植入物和 93%（13/14）的狒狒植入物在 1 个月时仍然通畅，这表明为了临床应用，对血管移植物进行测试，复制端侧方法很重要。本研究描述了可行的临床前手术程序，即使在小动物中也能模拟临床血管旁路移植物。在这些动物或其他动物中广泛实施这些端侧手术技术，应能提高实验性、临床前测试的质量，最终增加将新型血管移植物技术转化为临床应用的可能性。
