Li Yuanming, Zhou Ying, Qiao Weihua, Shi Jiawei, Qiu Xuefeng, Dong Nianguo
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Bioeng Biotechnol. 2023 Jan 6;10:1081233. doi: 10.3389/fbioe.2022.1081233. eCollection 2022.
Coronary artery bypass grafting (CABG) remains the most common procedure used in cardiovascular surgery for the treatment of severe coronary atherosclerotic heart disease. In coronary artery bypass grafting, small-diameter vascular grafts can potentially replace the vessels of the patient. The complete retention of the extracellular matrix, superior biocompatibility, and non-immunogenicity of the decellularized vascular matrix are unique advantages of small-diameter tissue-engineered vascular grafts. However, after vascular implantation, the decellularized vascular matrix is also subject to thrombosis and neoplastic endothelial hyperplasia, the two major problems that hinder its clinical application. The keys to improving the long-term patency of the decellularized matrix as vascular grafts include facilitating early endothelialization and avoiding intravascular thrombosis. This review article sequentially introduces six aspects of the decellularized vascular matrix as follows: design criteria of vascular grafts, components of the decellularized vascular matrix, the changing sources of the decellularized vascular matrix, the advantages and shortcomings of decellularization technologies, modification methods and the commercialization progress as well as the application prospects in small-diameter vascular grafts.
冠状动脉旁路移植术（CABG）仍然是心血管外科中用于治疗严重冠状动脉粥样硬化性心脏病最常用的手术。在冠状动脉旁路移植术中，小口径血管移植物有可能替代患者自身血管。去细胞血管基质完全保留细胞外基质、具有卓越的生物相容性和非免疫原性，这些都是小口径组织工程血管移植物的独特优势。然而，血管植入后，去细胞血管基质也会出现血栓形成和肿瘤性内皮细胞增生这两个阻碍其临床应用的主要问题。提高去细胞基质作为血管移植物长期通畅率的关键包括促进早期内皮化和避免血管内血栓形成。这篇综述文章依次介绍了去细胞血管基质的六个方面，如下：血管移植物的设计标准、去细胞血管基质的成分、去细胞血管基质的来源变化、去细胞技术的优缺点、改性方法及商业化进展以及在小口径血管移植物中的应用前景。
