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Chen YG, Dombaxe C, D'Amato AR, Van Herck S, Welch H, Fu Q, Zhang S, Wang Y. Transformation of metallo-elastomer grafts in a carotid artery interposition model over a year. Biomaterials 2024; 309:122598. [PMID: 38696943 DOI: 10.1016/j.biomaterials.2024.122598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/04/2024]
Abstract
Current vascular grafts, primarily Gore-Tex® and Dacron®, don't integrate with the host and have low patency in small-diameter vessels (<6 mm). Biomaterials that possess appropriate viscoelasticity, compliance, and high biocompatibility are essential for their application in small blood vessels. We have developed metal ion crosslinked poly(propanediol-co-(hydroxyphenyl methylene)amino-propanediol sebacate) (M-PAS), a biodegradable elastomer with a wide range of mechanical properties. We call these materials metallo-elastomers. An initial test on Zn-, Fe-, and Cu-PAS grafts reveals that Cu-PAS is the most suitable because of its excellent elastic recoil and well-balanced polymer degradation/tissue regeneration rate. Here we report host remodeling of Cu-PAS vascular grafts in rats over one year. 76 % of the grafts remain patent and >90 % of the synthetic polymer is degraded by 12 months. Extensive cell infiltration leads to a positive host remodeling. The remodeled grafts feature a fully endothelialized lumen. Circumferentially organized smooth muscle cells, elastin fibers, and widespread mature collagen give the neoarteries mechanical properties similar to native arteries. Proteomic analysis further reveals the presence of important vascular proteins in the neoarteries. Evidence suggests that Cu-PAS is a promising material for engineering small blood vessels.
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Affiliation(s)
- Ying Grace Chen
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | - Catia Dombaxe
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | | | - Simon Van Herck
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | - Halle Welch
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA
| | - Qin Fu
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14850, USA
| | - Sheng Zhang
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14850, USA
| | - Yadong Wang
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14850, USA.
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2
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Wang Z, Zhang M, Liu L, Mithieux SM, Weiss AS. Polyglycerol sebacate-based elastomeric materials for arterial regeneration. J Biomed Mater Res A 2024; 112:574-585. [PMID: 37345954 DOI: 10.1002/jbm.a.37583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/15/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
Synthetic vascular grafts are commonly used in patients with severe occlusive arterial disease when autologous grafts are not an option. Commercially available synthetic grafts are confronted with challenging outcomes: they have a lower patency rate than autologous grafts and are currently unable to promote arterial regeneration. Polyglycerol sebacate (PGS), a non-toxic polymer with a tunable degradation profile, has shown promising results as a small-diameter vascular graft component that can support the formation of neoarteries. In this review, we first present an overview of the synthesis and modification of PGS followed by an examination of its mechanical properties. We then report on the performance, degradation, regeneration, and remodeling of PGS-based small-diameter vascular grafts, with a focus on efforts to reduce thrombosis, prevent dilation, and promote cellular residency and extracellular matrix regeneration that resembles the native artery in spatial distribution and organization. We also highlight recent advances in the incorporation of novel in situ cell sources for arterial regeneration and their potential application in PGS-based vascular grafts. Finally, we compare vascular grafts fabricated using PGS-based materials with other elastomeric alternatives.
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Affiliation(s)
- Ziyu Wang
- School of Life and Environmental Sciences, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Miao Zhang
- School of Life and Environmental Sciences, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Linyang Liu
- School of Life and Environmental Sciences, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Suzanne M Mithieux
- School of Life and Environmental Sciences, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Anthony S Weiss
- School of Life and Environmental Sciences, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
- The University of Sydney Nano Institute, University of Sydney, Camperdown, New South Wales, Australia
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3
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Ding X, Zhang Z, Kluka C, Asim S, Manuel J, Lee BP, Jiang J, Heiden PA, Heldt CL, Rizwan M. Pair of Functional Polyesters That Are Photo-Cross-Linkable and Electrospinnable to Engineer Elastomeric Scaffolds with Tunable Structure and Properties. ACS APPLIED BIO MATERIALS 2024; 7:863-878. [PMID: 38207114 PMCID: PMC10954299 DOI: 10.1021/acsabm.3c00894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
A pair of alkyne- and thiol-functionalized polyesters are designed to engineer elastomeric scaffolds with a wide range of tunable material properties (e.g., thermal, degradation, and mechanical properties) for different tissues, given their different host responses, mechanics, and regenerative capacities. The two prepolymers are quickly photo-cross-linkable through thiol-yne click chemistry to form robust elastomers with small permanent deformations. The elastic moduli can be easily tuned between 0.96 ± 0.18 and 7.5 ± 2.0 MPa, and in vitro degradation is mediated from hours up to days by adjusting the prepolymer weight ratios. These elastomers bear free hydroxyl and thiol groups with a water contact angle of less than 85.6 ± 3.58 degrees, indicating a hydrophilic nature. The elastomer is compatible with NIH/3T3 fibroblast cells with cell viability reaching 88 ± 8.7% relative to the TCPS control at 48 h incubation. Differing from prior soft elastomers, a mixture of the two prepolymers without a carrying polymer is electrospinnable and UV-cross-linkable to fabricate elastic fibrous scaffolds for soft tissues. The designed prepolymer pair can thus ease the fabrication of elastic fibrous conduits, leading to potential use as a resorbable synthetic graft. The elastomers could find use in other tissue engineering applications as well.
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Affiliation(s)
- Xiaochu Ding
- Health Research Institute, Michigan Technological University, 202E Chemical Sciences and Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
- Department of Chemistry, Michigan Technological University, 609 Chemical Sciences and Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Zhongtian Zhang
- Department of Biomedical Engineering, Michigan Technological University, 309 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Christopher Kluka
- Department of Materials Science and Engineering, Michigan Technological University, 609 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Saad Asim
- Department of Biomedical Engineering, Michigan Technological University, 309 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - James Manuel
- Department of Biomedical Engineering, Michigan Technological University, 309 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Bruce P. Lee
- Department of Biomedical Engineering, Michigan Technological University, 309 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Jingfeng Jiang
- Health Research Institute, Michigan Technological University, 202E Chemical Sciences and Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
- Department of Biomedical Engineering, Michigan Technological University, 309 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Patricia A. Heiden
- Department of Chemistry, Michigan Technological University, 609 Chemical Sciences and Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Caryn L. Heldt
- Health Research Institute, Michigan Technological University, 202E Chemical Sciences and Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
- Department of Chemical Engineering, Michigan Technological University, 203 Chemical Sciences and Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
| | - Muhammad Rizwan
- Department of Biomedical Engineering, Michigan Technological University, 309 Minerals & Materials Engineering Building, 1400 Townsend Drive, Houghton, MI 49931
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Dokuchaeva AA, Mochalova AB, Timchenko TP, Kuznetsova EV, Podolskaya KS, Pashkovskaya OA, Filatova NA, Vaver AA, Zhuravleva IY. Remote Outcomes with Poly-ε-Caprolactone Aortic Grafts in Rats. Polymers (Basel) 2023; 15:4304. [PMID: 37959984 PMCID: PMC10649699 DOI: 10.3390/polym15214304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Poly-ε-caprolactone ((1,7)-polyoxepan-2-one; PCL) is a biodegradable polymer widely used in various fields of bioengineering, but its behavior in long-term studies appears to depend on many conditions, such as application specificity, chemical structure, in vivo test systems, and even environmental conditions in which the construction is exploited in. In this study, we offer an observation of the remote outcomes of PCL tubular grafts for abdominal aorta replacement in an in vivo experiment on a rat model. Adult Wistar rats were implanted with PCL vascular matrices and observed for 180 days. The results of ultrasound diagnostics and X-ray tomography (CBCT) show that the grafts maintained patency for the entire follow-up period without thrombosis, leakage, or interruptions, but different types of tissue reactions were found at this time point. By the day of examination, all the implants revealed a confluent endothelial monolayer covering layers of hyperplastic neointima formed on the luminal surface of the grafts. Foreign body reactions were found in several explants including those without signs of stenosis. Most of the scaffolds showed a pronounced infiltration with fibroblastic cells. All the samples revealed subintimal calcium phosphate deposits. A correlation between chondroid metaplasia in profound cells of neointima and the process of mineralization was supported by immunohistochemical (IHC) staining for S100 proteins and EDS mapping. Microscopy showed that the scaffolds with an intensive inflammatory response or formed fibrotic capsules retain their fibrillar structure even on day 180 after implantation, but matrices infiltrated with viable cells partially save the original fibrillary network. This research highlights the advantages of PCL vascular scaffolds, such as graft permeability, revitalization, and good surgical outcomes. The disadvantages are low biodegradation rates and exceptionally high risks of mineralization and intimal hyperplasia.
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Affiliation(s)
- Anna A. Dokuchaeva
- Institute of Experimental Biology and Medicine, E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.B.M.); (T.P.T.); (E.V.K.); (K.S.P.); (O.A.P.); (N.A.F.); (A.A.V.); (I.Y.Z.)
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5
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Rohringer S, Grasl C, Ehrmann K, Hager P, Hahn C, Specht SJ, Walter I, Schneider KH, Zopf LM, Baudis S, Liska R, Schima H, Podesser BK, Bergmeister H. Biodegradable, Self-Reinforcing Vascular Grafts for In Situ Tissue Engineering Approaches. Adv Healthc Mater 2023; 12:e2300520. [PMID: 37173073 DOI: 10.1002/adhm.202300520] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Clinically available small-diameter synthetic vascular grafts (SDVGs) have unsatisfactory patency rates due to impaired graft healing. Therefore, autologous implants are still the gold standard for small vessel replacement. Bioresorbable SDVGs may be an alternative, but many polymers have inadequate biomechanical properties that lead to graft failure. To overcome these limitations, a new biodegradable SDVG is developed to ensure safe use until adequate new tissue is formed. SDVGs are electrospun using a polymer blend composed of thermoplastic polyurethane (TPU) and a new self-reinforcing TP(U-urea) (TPUU). Biocompatibility is tested in vitro by cell seeding and hemocompatibility tests. In vivo performance is evaluated in rats over a period for up to six months. Autologous rat aortic implants serve as a control group. Scanning electron microscopy, micro-computed tomography (µCT), histology, and gene expression analyses are applied. TPU/TPUU grafts show significant improvement of biomechanical properties after water incubation and exhibit excellent cyto- and hemocompatibility. All grafts remain patent, and biomechanical properties are sufficient despite wall thinning. No inflammation, aneurysms, intimal hyperplasia, or thrombus formation are observed. Evaluation of graft healing shows similar gene expression profiles of TPU/TPUU and autologous conduits. These new biodegradable, self-reinforcing SDVGs may be promising candidates for clinical use in the future.
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Affiliation(s)
- Sabrina Rohringer
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Christian Grasl
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Katharina Ehrmann
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Institute of Applied Synthetic Chemistry, Technical University of Vienna, Getreidemarkt 9/163, Vienna, 1060, Austria
| | - Pia Hager
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Clemens Hahn
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Sophie J Specht
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Ingrid Walter
- Department of Pathobiology, University of Veterinary Medicine, Veterinaerplatz 1, Vienna, 1210, Austria
| | - Karl H Schneider
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Lydia M Zopf
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Traumatology, Donaueschingenstraße 13, Vienna, 1200, Austria
| | - Stefan Baudis
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Institute of Applied Synthetic Chemistry, Technical University of Vienna, Getreidemarkt 9/163, Vienna, 1060, Austria
| | - Robert Liska
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Institute of Applied Synthetic Chemistry, Technical University of Vienna, Getreidemarkt 9/163, Vienna, 1060, Austria
| | - Heinrich Schima
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Bruno K Podesser
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
| | - Helga Bergmeister
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna, 1090, Austria
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, Vienna, 1200, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Gürtel 18-20, Vienna, 1090, Austria
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6
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Tan W, Boodagh P, Selvakumar PP, Keyser S. Strategies to counteract adverse remodeling of vascular graft: A 3D view of current graft innovations. Front Bioeng Biotechnol 2023; 10:1097334. [PMID: 36704297 PMCID: PMC9871289 DOI: 10.3389/fbioe.2022.1097334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Vascular grafts are widely used for vascular surgeries, to bypass a diseased artery or function as a vascular access for hemodialysis. Bioengineered or tissue-engineered vascular grafts have long been envisioned to take the place of bioinert synthetic grafts and even vein grafts under certain clinical circumstances. However, host responses to a graft device induce adverse remodeling, to varied degrees depending on the graft property and host's developmental and health conditions. This in turn leads to invention or failure. Herein, we have mapped out the relationship between the design constraints and outcomes for vascular grafts, by analyzing impairment factors involved in the adverse graft remodeling. Strategies to tackle these impairment factors and counteract adverse healing are then summarized by outlining the research landscape of graft innovations in three dimensions-cell technology, scaffold technology and graft translation. Such a comprehensive view of cell and scaffold technological innovations in the translational context may benefit the future advancements in vascular grafts. From this perspective, we conclude the review with recommendations for future design endeavors.
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Affiliation(s)
- Wei Tan
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, United States,*Correspondence: Wei Tan,
| | - Parnaz Boodagh
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Sean Keyser
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, United States
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7
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Godinho B, Gama N, Ferreira A. Different methods of synthesizing poly(glycerol sebacate) (PGS): A review. Front Bioeng Biotechnol 2022; 10:1033827. [PMID: 36532580 PMCID: PMC9748623 DOI: 10.3389/fbioe.2022.1033827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/10/2022] [Indexed: 08/24/2023] Open
Abstract
Poly(glycerol sebacate) (PGS) is a biodegradable elastomer that has attracted increasing attention as a potential material for applications in biological tissue engineering. The conventional method of synthesis, first described in 2002, is based on the polycondensation of glycerol and sebacic acid, but it is a time-consuming and energy-intensive process. In recent years, new approaches for producing PGS, PGS blends, and PGS copolymers have been reported to not only reduce the time and energy required to obtain the final material but also to adjust the properties and processability of the PGS-based materials based on the desired applications. This review compiles more than 20 years of PGS synthesis reports, reported inconsistencies, and proposed alternatives to more rapidly produce PGS polymer structures or PGS derivatives with tailor-made properties. Synthesis conditions such as temperature, reaction time, reagent ratio, atmosphere, catalysts, microwave-assisted synthesis, and PGS modifications (urethane and acrylate groups, blends, and copolymers) were revisited to present and discuss the diverse alternatives to produce and adapt PGS.
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Affiliation(s)
- Bruno Godinho
- CICECO-Aveiro Institute of Materials, University of Aveiro, Aveiro, Portugal
| | - Nuno Gama
- CICECO-Aveiro Institute of Materials, University of Aveiro, Aveiro, Portugal
| | - Artur Ferreira
- CICECO-Aveiro Institute of Materials, University of Aveiro, Aveiro, Portugal
- ESTGA-Águeda School of Technology and Management, Águeda, Portugal
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Small Diameter Cell-Free Tissue-Engineered Vascular Grafts: Biomaterials and Manufacture Techniques to Reach Suitable Mechanical Properties. Polymers (Basel) 2022; 14:polym14173440. [PMID: 36080517 PMCID: PMC9460130 DOI: 10.3390/polym14173440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 12/25/2022] Open
Abstract
Vascular grafts (VGs) are medical devices intended to replace the function of a blood vessel. Available VGs in the market present low patency rates for small diameter applications setting the VG failure. This event arises from the inadequate response of the cells interacting with the biomaterial in the context of operative conditions generating chronic inflammation and a lack of regenerative signals where stenosis or aneurysms can occur. Tissue Engineered Vascular grafts (TEVGs) aim to induce the regeneration of the native vessel to overcome these limitations. Besides the biochemical stimuli, the biomaterial and the particular micro and macrostructure of the graft will determine the specific behavior under pulsatile pressure. The TEVG must support blood flow withstanding the exerted pressure, allowing the proper compliance required for the biomechanical stimulation needed for regeneration. Although the international standards outline the specific requirements to evaluate vascular grafts, the challenge remains in choosing the proper biomaterial and manufacturing TEVGs with good quality features to perform satisfactorily. In this review, we aim to recognize the best strategies to reach suitable mechanical properties in cell-free TEVGs according to the reported success of different approaches in clinical trials and pre-clinical trials.
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Grajciarová M, Turek D, Malečková A, Pálek R, Liška V, Tomášek P, Králičková M, Tonar Z. Are ovine and porcine carotid arteries equivalent animal models for experimental cardiac surgery: A quantitative histological comparison. Ann Anat 2022; 242:151910. [PMID: 35189268 DOI: 10.1016/j.aanat.2022.151910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Coronary artery bypass grafting (CABG) is a common cardiac surgery. Manufacturing small-diameter (2-5mm) vascular grafts for CABG is important for patients who lack first-choice autologous arterial, or venous conduits. Ovine and porcine common carotid arteries (CCAs) are used as large animal models for in vivo testing of newly developed tissue-engineered arterial grafts. It is unknown to what extent these models are interchangeable and whether the left and right arteries of the same subjects can be used as experimental controls. Therefore, we compared the microscopic structure of paired left and right ovine and porcine CCAs in the proximodistal direction and compared these animal model samples to samples of human coronary arteries (CAs) and human internal thoracic arteries (ITAs). METHODS We compared the histological composition of whole CCAs of sheep (n=22 animals) with whole porcine CCAs (n=21), segments of human CAs (n=21), and human ITAs (n=21). Using unbiased sampling and stereological methods, we quantified the fractions of elastin, total collagen, type I collagen, type III collagen, smooth muscle actin (SMA) and chondroitin sulfate (CS) A, B, and C. We also quantified the densities and distributions of nuclear profiles, nervi vasorum and vasa vasorum as well as the thickness of the intima-media and total wall thickness. RESULTS The differences between the paired samples of left and right CCAs in sheep were substantially greater than the differences in laterality in porcine CCAs. The right ovine CCAs had a smaller fraction of elastin (p<0.001), greater fraction of SMA (p<0.01), and greater intima-media thickness (p<0.001) than the paired left side CCAs. In pigs, the right CCAs had a greater fraction of elastin (p<0.05) and a greater density of vasa vasorum in the media (p<0.001) than the left-side CCAs. The fractions of elastin and CS decreased and the fraction of SMA increased in the proximodistal direction in both the ovine (p<0.001) and porcine (p<0.001) CCAs. Ovine CCAs had a muscular phenotype along their entire length, but porcine CCAs were elastic-type arteries in the proximal segments but muscular type arteries in middle and distal segments. The CCAs of both animals differed from the human CAs and ITAs in most parameters, but the ovine CCAs had a comparable fraction of elastin and CS to human ITAs. CONCLUSIONS From a histological point of view, ovine and porcine CCAs were not equivalent in most quantitative parameters to human CAs and ITAs. Left and right ovine CCAs did not have the same histological composition, which is limiting for their mutual equivalence as sham-operated controls in experiments. These differences should be taken into account when designing and interpreting experiments using these models in cardiac surgery. The complete morphometric data obtained by quantitative evaluation of arterial segments were provided to facilitate the power analysis necessary for justification of the minimum number of samples when planning further experiments. The middle or distal segments of ovine and porcine CCAs remain the most realistic and the best characterized large animal models for testing artificial arterial CABG conduits.
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Affiliation(s)
- Martina Grajciarová
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Daniel Turek
- First Faculty of Medicine, Charles University, Katerinska 32, 121 08 Prague 2, Czech Republic; Department of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech Republic
| | - Anna Malečková
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Richard Pálek
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Husova 3, 306 05 Pilsen, Czech Republic
| | - Václav Liška
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Husova 3, 306 05 Pilsen, Czech Republic
| | - Petr Tomášek
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic; Department of Forensic Medicine, Second Faculty of Medicine, Charles University and Na Bulovce Hospital, Budinova 2, 180 81 Prague, Czech Republic
| | - Milena Králičková
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Zbyněk Tonar
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic.
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10
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Wei Y, Wang F, Guo Z, Zhao Q. Tissue-engineered vascular grafts and regeneration mechanisms. J Mol Cell Cardiol 2021; 165:40-53. [PMID: 34971664 DOI: 10.1016/j.yjmcc.2021.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 02/07/2023]
Abstract
Cardiovascular diseases (CVDs) are life-threatening diseases with high morbidity and mortality worldwide. Vascular bypass surgery is still the ultimate strategy for CVD treatment. Autografts are the gold standard for graft transplantation, but insufficient sources limit their widespread application. Therefore, alternative tissue engineered vascular grafts (TEVGs) are urgently needed. In this review, we summarize the major strategies for the preparation of vascular grafts, as well as the factors affecting their patency and tissue regeneration. Finally, the underlying mechanisms of vascular regeneration that are mediated by host cells are discussed.
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Affiliation(s)
- Yongzhen Wei
- Zhengzhou Cardiovascular Hospital and 7th People's Hospital of Zhengzhou, Zhengzhou, Henan Province, China; State key Laboratory of Medicinal Chemical Biology & Key Laboratory of Bioactive Materials (Ministry of Education), College of Life Sciences, Nankai University, Tianjin, China
| | - Fei Wang
- State key Laboratory of Medicinal Chemical Biology & Key Laboratory of Bioactive Materials (Ministry of Education), College of Life Sciences, Nankai University, Tianjin, China
| | - Zhikun Guo
- Zhengzhou Cardiovascular Hospital and 7th People's Hospital of Zhengzhou, Zhengzhou, Henan Province, China
| | - Qiang Zhao
- Zhengzhou Cardiovascular Hospital and 7th People's Hospital of Zhengzhou, Zhengzhou, Henan Province, China; State key Laboratory of Medicinal Chemical Biology & Key Laboratory of Bioactive Materials (Ministry of Education), College of Life Sciences, Nankai University, Tianjin, China.
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11
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Turner B, Ramesh S, Menegatti S, Daniele M. Resorbable elastomers for implantable medical devices: highlights and applications. POLYM INT 2021. [DOI: 10.1002/pi.6349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Brendan Turner
- Joint Department of Biomedical Engineering North Carolina State University and University of Chapel Hill Raleigh NC USA
- Department of Chemical and Biomolecular Engineering North Carolina State University Raleigh NC USA
| | - Srivatsan Ramesh
- Department of Chemical and Biomolecular Engineering North Carolina State University Raleigh NC USA
| | - Stefano Menegatti
- Department of Chemical and Biomolecular Engineering North Carolina State University Raleigh NC USA
| | - Michael Daniele
- Joint Department of Biomedical Engineering North Carolina State University and University of Chapel Hill Raleigh NC USA
- Department of Electrical and Computer Engineering North Carolina State University Raleigh NC USA
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12
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Antonova LV, Krivkina EO, Sevostianova VV, Mironov AV, Rezvova MA, Shabaev AR, Tkachenko VO, Krutitskiy SS, Khanova MY, Sergeeva TY, Matveeva VG, Glushkova TV, Kutikhin AG, Mukhamadiyarov RA, Deeva NS, Akentieva TN, Sinitsky MY, Velikanova EA, Barbarash LS. Tissue-Engineered Carotid Artery Interposition Grafts Demonstrate High Primary Patency and Promote Vascular Tissue Regeneration in the Ovine Model. Polymers (Basel) 2021; 13:polym13162637. [PMID: 34451177 PMCID: PMC8400235 DOI: 10.3390/polym13162637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/24/2022] Open
Abstract
Tissue-engineered vascular graft for the reconstruction of small arteries is still an unmet clinical need, despite the fact that a number of promising prototypes have entered preclinical development. Here we test Poly(3-hydroxybutyrate-co-3-hydroxyvalerate)Poly(ε-caprolactone) 4-mm-diameter vascular grafts equipped with vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and stromal cell-derived factor 1α (SDF-1α) and surface coated with heparin and iloprost (PHBV/PCL[VEGF-bFGF-SDF]Hep/Ilo, n = 8) in a sheep carotid artery interposition model, using biostable vascular prostheses of expanded poly(tetrafluoroethylene) (ePTFE, n = 5) as a control. Primary patency of PHBV/PCL[VEGF-bFGF-SDF]Hep/Ilo grafts was 62.5% (5/8) at 24 h postimplantation and 50% (4/8) at 18 months postimplantation, while all (5/5) ePTFE conduits were occluded within the 24 h after the surgery. At 18 months postimplantation, PHBV/PCL[VEGF-bFGF-SDF]Hep/Ilo grafts were completely resorbed and replaced by the vascular tissue. Regenerated arteries displayed a hierarchical three-layer structure similar to the native blood vessels, being fully endothelialised, highly vascularised and populated by vascular smooth muscle cells and macrophages. The most (4/5, 80%) of the regenerated arteries were free of calcifications but suffered from the aneurysmatic dilation. Therefore, biodegradable PHBV/PCL[VEGF-bFGF-SDF]Hep/Ilo grafts showed better short- and long-term results than bio-stable ePTFE analogues, although these scaffolds must be reinforced for the efficient prevention of aneurysms.
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Affiliation(s)
- Larisa V. Antonova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Evgenia O. Krivkina
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Viktoriia V. Sevostianova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
- Correspondence: ; Tel.: +7-9069356076
| | - Andrey V. Mironov
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Maria A. Rezvova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Amin R. Shabaev
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Vadim O. Tkachenko
- Budker Institute of Nuclear Physics of Siberian Branch Russian Academy of Sciences, 630090 Novosibirsk, Russia;
| | - Sergey S. Krutitskiy
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Mariam Yu. Khanova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Tatiana Yu. Sergeeva
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Vera G. Matveeva
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Tatiana V. Glushkova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Anton G. Kutikhin
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Rinat A. Mukhamadiyarov
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Nadezhda S. Deeva
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Tatiana N. Akentieva
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Maxim Yu. Sinitsky
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Elena A. Velikanova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
| | - Leonid S. Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia; (L.V.A.); (E.O.K.); (A.V.M.); (M.A.R.); (A.R.S.); (S.S.K.); (M.Y.K.); (T.Y.S.); (V.G.M.); (T.V.G.); (A.G.K.); (R.A.M.); (N.S.D.); (T.N.A.); (M.Y.S.); (E.A.V.); (L.S.B.)
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13
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Heparin-Eluting Tissue-Engineered Bioabsorbable Vascular Grafts. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11104563] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The creation of small-diameter tissue-engineered vascular grafts using biodegradable materials has the potential to change the quality of cardiovascular surgery in the future. The implantation of these tissue-engineered arterial grafts has yet to reach clinical application. One of the reasons for this is thrombus occlusion of the graft in the acute phase. In this paper, we first describe the causes of accelerated thrombus formation and discuss the drugs that are thought to inhibit thrombus formation. We then review the latest research on methods to locally bind the anticoagulant heparin to biodegradable materials and methods to extend the duration of sustained heparin release. We also discuss the results of studies using large animal models and the challenges that need to be overcome for future clinical applications.
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Vogt L, Ruther F, Salehi S, Boccaccini AR. Poly(Glycerol Sebacate) in Biomedical Applications-A Review of the Recent Literature. Adv Healthc Mater 2021; 10:e2002026. [PMID: 33733604 DOI: 10.1002/adhm.202002026] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/10/2021] [Indexed: 12/13/2022]
Abstract
Poly(glycerol sebacate) (PGS) continues to attract attention for biomedical applications owing to its favorable combination of properties. Conventionally polymerized by a two-step polycondensation of glycerol and sebacic acid, variations of synthesis parameters, reactant concentrations or by specific chemical modifications, PGS materials can be obtained exhibiting a wide range of physicochemical, mechanical, and morphological properties for a variety of applications. PGS has been extensively used in tissue engineering (TE) of cardiovascular, nerve, cartilage, bone and corneal tissues. Applications of PGS based materials in drug delivery systems and wound healing are also well documented. Research and development in the field of PGS continue to progress, involving mainly the synthesis of modified structures using copolymers, hybrid, and composite materials. Moreover, the production of self-healing and electroactive materials has been introduced recently. After almost 20 years of research on PGS, previous publications have outlined its synthesis, modification, properties, and biomedical applications, however, a review paper covering the most recent developments in the field is lacking. The present review thus covers comprehensively literature of the last five years on PGS-based biomaterials and devices focusing on advanced modifications of PGS for applications in medicine and highlighting notable advances of PGS based systems in TE and drug delivery.
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Affiliation(s)
- Lena Vogt
- Institute of Biomaterials University Erlangen‐Nuremberg Erlangen 91058 Germany
| | - Florian Ruther
- Institute of Biomaterials University Erlangen‐Nuremberg Erlangen 91058 Germany
| | - Sahar Salehi
- Chair of Biomaterials University of Bayreuth Bayreuth 95447 Germany
| | - Aldo R. Boccaccini
- Institute of Biomaterials University Erlangen‐Nuremberg Erlangen 91058 Germany
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