The Human Acellular Vessel (HAV) as a vascular conduit for infrainguinal arterial bypass

Budget impact model of acellular tissue engineered vessel for the repair of extremity arterial trauma when autologous vein is not feasible

AIMS

To predict the budget impact of Symvess (Symvess is a trademark of Humacyte Global, Inc.) (acellular tissue engineered vessel-tyod [ATEV]) for extremity arterial trauma repair when autologous vein repair is not feasible.

MATERIALS AND METHODS

The 3-year budget impact of adding ATEV as a repair option alongside autologous vein, prosthetic graft, and "non-autologous other" grafts was evaluated from the perspectives of a Level I trauma center and third-party commercial payers. Conduit-specific complication rates were obtained from two clinical studies for ATEV and from the published literature and analysis of the PROOVIT registry for other conduits. Costs were compared pre- and post-ATEV availability. Conduit-related costs and complications included conduit infections, amputations, vein harvest site infection, surgical re-interventions, rehabilitation after amputation, and 12-month post-discharge costs. Impact on operating room (OR) time and readmissions was evaluated. A sensitivity analysis was conducted to evaluate parameter uncertainty.

RESULTS

With introduction of ATEV, there was a 29.8% reduction in amputations and a 29.5% reduction in graft infections over 3 years. From a Level I trauma center perspective, seven patients were expected to receive an ATEV over 3 years, with cumulative cost savings of $80,650 (2.3% decrease). OR time would decrease by 8.6 h, and readmission-related costs would be reduced by 16.7% with ATEV availability. From the third-party commercial payer perspective, 35 patients were expected to receive ATEV, with a budget impact showing a savings of -$0.08 per member per month after 3 years. For trauma centers, sensitivity analysis showed that cost drivers were amputation risk associated with "non-autologous other" graft types and market share of autologous vein (short ischemia time).

LIMITATIONS

Uncertainty surrounding model parameters.

CONCLUSIONS

ATEV was projected to be cost-saving over 3 years for both trauma centers and third-party payers due to reductions in the costs related to amputations and conduit infections.

[3D printing in surgery: relevance of technology maturity assessment in bioprinting research studies]

Biological 3D printing (bioprinting) is an extension of what is defined as additive manufacturing in the American Society for Testing and Materials (ASTM) and International Organization for Standardization (ISO) standards and is based on the automated printing of living cells and biomaterials. Researchers and experts in the field of biomaterial science, tissue engineering and regenerative medicine (TE&RM) are constantly pointing to the potential of biological 3D printing and scientific articles regularly announce the imminent clinical application. We argue in this article that these announcements are often premature and counterproductive as they focus heavily on technological progress but regularly ignore the critical stages that need to be completed in order to successfully translate a technology into the healthcare market. The technology readiness level (TRL) scale is a potentially useful tool for measuring the relative maturity of a technology in terms of overcoming a series of critical milestones. We propose an adaptation of the TRL scale and use it to discuss the current state of research on biological 3D printing. Finally, we provide specific recommendations for optimizing future research projects to pave the way for clinical applications of biological 3D printing and thus achieve a direct positive impact on surgical patient care.

Mapping the blueprint of artificial blood vessels research: a bibliometric analysis

BACKGROUND

Vascular diseases represent a significant cause of disability and death worldwide. The demand for artificial blood vessels is increasing due to the scarce supply of healthy autologous vessels. Nevertheless, the literature in this area remains sparse and inconclusive.

METHODS

Bibliometrics is the study of quantitative analysis of publications and their patterns. This study conducts a bibliometric analysis of publications on artificial blood vessels in the 21st century, examining performance distribution, research trajectories, the evolution of research hotspots, and the exploration of the knowledge base. This approach provides comprehensive insights into the knowledge structure of the field.

RESULTS

The search retrieved 2060 articles, showing a consistent rise in the publication volume and average annual citation frequency related to artificial blood vessels research. The United States is at the forefront of high-quality publications and international collaborations. Among academic institutions, Yale University is a leading contributor. The dominant disciplines within the artificial blood vessels sector include engineering, biomedical sciences, materials science, biomaterials science, and surgery, with surgery experiencing the most rapid expansion.

CONCLUSIONS

This study is the inaugural effort to bibliometrically analyze and visualize the scholarly output in the domain of artificial blood vessels. It provides clinicians and researchers with a reliable synopsis of the field's current state, offering a reference point for existing research and suggesting new avenues for future investigations.