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Tanaka T, Tanaka R, Ogawa Y, Takagi Y, Sata M, Asakura T. Evaluation of small-diameter silk vascular grafts implanted in dogs. JTCVS OPEN 2021; 6:148-156. [PMID: 36003556 PMCID: PMC9390453 DOI: 10.1016/j.xjon.2021.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022]
Abstract
Objectives Methods Results Conclusions
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Tanaka T, Abe Y, Cheng CJ, Tanaka R, Naito A, Asakura T. Development of Small-Diameter Elastin-Silk Fibroin Vascular Grafts. Front Bioeng Biotechnol 2021; 8:622220. [PMID: 33585421 PMCID: PMC7874157 DOI: 10.3389/fbioe.2020.622220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
Globally, increasing mortality from cardiovascular disease has become a problem in recent years. Vascular replacement has been used as a treatment for these diseases, but with blood vessels <6 mm in diameter, existing vascular grafts made of synthetic polymers can be occluded by thrombus formation or intimal hyperplasia. Therefore, the development of new artificial vascular grafts is desirable. In this study, we developed an elastin (EL)-silk fibroin (SF) double-raschel knitted vascular graft 1.5 mm in diameter. Water-soluble EL was prepared from insoluble EL by hydrolysis with oxalic acid. Compared to SF, EL was less likely to adhere to platelets, while vascular endothelial cells were three times more likely to adhere. SF artificial blood vessels densely packed with porous EL were fabricated, and these prevented the leakage of blood from the graft during implantation, while the migration of cells after implantation was promoted. Several kinds of 13C solid-state NMR spectra were observed with the EL-SF grafts in dry and hydrated states. It was noted that the EL molecules in the graft had very high mobility in the hydrated state. The EL-SF grafts were implanted into the abdominal aorta of rats to evaluate their patency and remodeling ability. No adverse reactions, such as bleeding at the time of implantation or disconnection of the sutured ends, were observed in the implanted grafts, and all were patent at the time of extraction. In addition, vascular endothelial cells were present on the graft's luminal surface 2 weeks after implantation. Therefore, we conclude that EL-SF artificial vascular grafts may be useful where small-diameter grafts are required.
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Affiliation(s)
- Takashi Tanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture & Technology, Fuchu, Japan
| | - Yasuyuki Abe
- Department of Biotechnology, Tokyo University of Agriculture & Technology, Koganei, Japan
| | - Chieh-Jen Cheng
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Ryo Tanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture & Technology, Fuchu, Japan
| | - Akira Naito
- Department of Biotechnology, Tokyo University of Agriculture & Technology, Koganei, Japan
| | - Tetsuo Asakura
- Department of Biotechnology, Tokyo University of Agriculture & Technology, Koganei, Japan
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Asakura T, Tanaka T, Tanaka R. Advanced Silk Fibroin Biomaterials and Application to Small-Diameter Silk Vascular Grafts. ACS Biomater Sci Eng 2019; 5:5561-5577. [PMID: 33405687 DOI: 10.1021/acsbiomaterials.8b01482] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As the incidences of cardiovascular diseases have been on the rise in recent years, the need for small-diameter artificial vascular grafts is increasing globally. Although synthetic polymers such as expanded polytetrafluoroethylene or poly(ethylene terephthalate) have been successfully used for artificial vascular grafts ≥6 mm in diameter, they fail at smaller diameters (<6 mm) due to thrombus formation and intimal hyperplasia. Thus, development of vascular grafts for small diameter vessel replacement that are <6 mm in diameter remains a major clinical challenge. Silk fibroin (SF) from Bombyx mori silkworm is well-known as an excellent textile and also has been used as suture material in surgery for more than 2000 years. Many attempts to develop small-diameter SF vascular grafts with <6 mm in diameter have been reported. Here, research and development in small-diameter vascular grafts with SF are reviewed as follows: (1) the heterogeneous structure of SF fiber (Silk II), including the packing arrangements and type II β-turn structure of SF (Silk I*) before spinning; (2) SF modified by transgenic silkworm, which is more suitable for vascular grafts; (3) preparation of small-diameter SF vascular grafts; (4) characterization of SF in the hydrated state, including dynamics of water molecules by nuclear magnetic resonance; and (5) evaluation of the SF grafts by in vivo implantation experiment. According to the findings, SF is a promising material for small-diameter vascular graft development.
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Affiliation(s)
- Tetsuo Asakura
- Department of Biotechnology, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588, Japan
| | - Takashi Tanaka
- Department of Biotechnology, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588, Japan
| | - Ryo Tanaka
- Department of Biotechnology, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588, Japan
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Tanaka T, Uemura A, Tanaka R, Tasei Y, Asakura T. Comparison of the knitted silk vascular grafts coated with fibroin sponges prepared using glycerin, poly(ethylene glycol diglycidyl ether) and poly(ethylene glycol) as porogens. J Biomater Appl 2018; 32:1239-1252. [PMID: 29448867 DOI: 10.1177/0885328218758276] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Development of a small-diameter artificial vascular graft is urgent because existing materials often occlude within a short time. We have shown that small-diameter vascular graft using Bombyx mori silk fibroin is a potential candidate. Silk fibroin grafts are fabricated by coating silk fibroin on the knit tube prepared from silk fibroin fibers. However, there is a serious problem that the coated silk fibroin portion hardens when alcohol is used for insolubilization of the coated silk fibroin. This hardening prevents the desired biodegradation of the coated silk fibroin. In this study, we improved the silk fibroin coating method of the knit silk fibroin tube. Namely, the silk fibroin sponge coating was performed using glycerin, poly(ethylene glycol diglycidyl ether) or poly(ethylene glycol). In addition, silk fibroin grafts were prepared avoiding dryness during the coating process and were kept in the hydrated state until implantation into the abdominal aorta was complete. After implantation of the hydrated silk fibroin grafts, grafts were taken out at two weeks or three months, and histopathological examination was performed. The grafts coated with three types of silk fibroin sponges had a higher tissue infiltration rate than alcohol-treated grafts and were superior in the formation of smooth muscle cell and vascular endothelial cell remodeling. Biodegradations of the silk fibroin grafts prepared using the three types of silk fibroin sponge coatings and alcohol-treated silk fibroin grafts were also examined with protease XIV in vitro, and the grafts were observed by scanning electron microscopy before and 24 h after biodegradation. Faster biodegradations were observed for grafts coated with the three types of silk fibroin sponges. 13C solid-state nuclear magnetic resonance studies showed that the conformation of the silk fibroin sponge prepared using porogen was a random coil with high mobility in the hydrated state. We believe that small-diameter silk fibroin vascular grafts coated with quick biodegradable silk fibroin sponges can be developed based on these findings.
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Affiliation(s)
- Takashi Tanaka
- 1 Veterinary Surgery, Tokyo University of Agriculture & Technology, Tokyo, Japan
| | - Akiko Uemura
- 1 Veterinary Surgery, Tokyo University of Agriculture & Technology, Tokyo, Japan
| | - Ryo Tanaka
- 1 Veterinary Surgery, Tokyo University of Agriculture & Technology, Tokyo, Japan
| | - Yugo Tasei
- 2 Biotechnology, Tokyo University of Agriculture & Technology, Tokyo, Japan
| | - Tetsuo Asakura
- 2 Biotechnology, Tokyo University of Agriculture & Technology, Tokyo, Japan
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5
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Evaluation of endothelialization in the center part of graft using 3 cm vascular grafts implanted in the abdominal aortae of the rat. J Artif Organs 2017; 20:221-229. [DOI: 10.1007/s10047-017-0957-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 03/25/2017] [Indexed: 01/22/2023]
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Abstract
There is a need for bioengineered therapies to improve the overall health of the growing and aging world population. Patients with renal failure have a life-long requirement for a durable form of hemodialysis vascular access. In this article, we review the history of tissue engineering as it pertains to bioengineered grafts and vessels for hemodialysis access. Over the years, various strategies have been utilized to develop ideal, humanized vessels for vascular replacement such as fixation of animal or human vessels, cell seeding of synthetic materials, and the synthesis of completely autologous or allogeneic bioengineered vessels. Tissue engineering technologies from two companies have progressed to reach phase 2 and phase 3 clinical trials, but the prospect of newer strategies on the horizon may offer improved manufacturing efficiency, a greater variety of conduit size and length, and reduce the cost to produce.
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Fukayama T, Ozai Y, Shimokawadoko H, Aytemiz D, Tanaka R, Machida N, Asakura T. Effect of fibroin sponge coating on in vivo performance of knitted silk small diameter vascular grafts. Organogenesis 2016; 11:137-51. [PMID: 26496652 DOI: 10.1080/15476278.2015.1093268] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Vascular grafts under 5 mm or less in diameter are not developed due to a problem caused by early thrombus formation, neointimal hyperplasia, etc. Bombyx mori silk fibroin (SF) which has biodegradability and tissue infiltration is focused as tube and coating material of vascular grafts. Coating is an important factor to maintain the strength of the anastomotic region of vascular grafts, and to prevent the blood leak from the vascular grafts after implantation. Therefore, in this research, we focused on the SF concentration of the coating solution, and tissue infiltration and remodeling were compared among each SF concentration. Silk poly (-ethylene) glycol diglycidyl ether (PGDE) coating with concentrations of 1.0%, 2.5%, 5.0%, and 7.5% SF were applied for the double-raschel knitted small-sized vessel with 1.5 mm diameter and 1cm in length. The grafts were implanted in the rat abdominal aorta and removed after 3 weeks or 3 months. Vascular grafts patency was monitored by ultrasound, and morphological evaluation was performed by histopathological examination. SF concentration had no significant effects on the patency rate. However, tissue infiltration was significantly higher in the sample of 2.5% SF in 3 weeks, and 1.0% and 2.5% SF in 3 months. Also, in comparison of length inside of the graft, stenosis were not found in 3 weeks, however, found with 5.0% and 7.5% in 3 months. From these results, it is clear that 2.5% SF coating is the most suitable concentration, based on the characteristics of less stenosis, early tissue infiltration, and less neointimal hyperplasia.
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Affiliation(s)
- Toshiharu Fukayama
- a Department of Veterinary Surgery ; Tokyo University of Agriculture & Technology ; Fuchu, Tokyo , Japan
| | - Yusuke Ozai
- a Department of Veterinary Surgery ; Tokyo University of Agriculture & Technology ; Fuchu, Tokyo , Japan
| | - Haruka Shimokawadoko
- b Department of Biotechnology ; Tokyo University of Agriculture & Technology; Koganei , Tokyo , Japan
| | - Derya Aytemiz
- b Department of Biotechnology ; Tokyo University of Agriculture & Technology; Koganei , Tokyo , Japan
| | - Ryou Tanaka
- a Department of Veterinary Surgery ; Tokyo University of Agriculture & Technology ; Fuchu, Tokyo , Japan
| | - Noboru Machida
- c Laboratory of Veterinary Clinical Oncology; Tokyo University of Agriculture & Technology ; Fuchu, Tokyo , Japan
| | - Tetsuo Asakura
- b Department of Biotechnology ; Tokyo University of Agriculture & Technology; Koganei , Tokyo , Japan
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Alsberg E, von Recum HA, Mahoney MJ. Environmental cues to guide stem cell fate decision for tissue engineering applications. Expert Opin Biol Ther 2006; 6:847-66. [PMID: 16918253 DOI: 10.1517/14712598.6.9.847] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The human body contains a variety of stem cells capable of both repeated self-renewal and production of specialised, differentiated progeny. Critical to the implementation of these cells in tissue engineering strategies is a thorough understanding of which external signals in the stem cell microenvironment provide cues to control their fate decision in terms of proliferation or differentiation into a desired, specific phenotype. These signals must then be incorporated into tissue regeneration approaches for regulated exposure to stem cells. The precise spatial and temporal presentation of factors directing stem cell behaviour is extremely important during embryogenesis, development and natural healing events, and it is possible that this level of control will be vital to the success of many regenerative therapies. This review covers existing tissue engineering approaches to guide the differentiation of three disparate stem cell populations: mesenchymal, neural and endothelial. These progenitor cells will be of central importance in many future connective, neural and vascular tissue regeneration technologies.
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Affiliation(s)
- Eben Alsberg
- Case Western Reserve University, Department of Biomedical Engineering, 10900 Euclid Avenue, Wickenden Building, Room 204, Cleveland, OH 44106-7207, USA.
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Kanki-Horimoto S, Horimoto H, Mieno S, Kishida K, Watanabe F, Furuya E, Katsumata T. Synthetic Vascular Prosthesis Impregnated With Mesenchymal Stem Cells Overexpressing Endothelial Nitric Oxide Synthase. Circulation 2006; 114:I327-30. [PMID: 16820594 DOI: 10.1161/circulationaha.105.001586] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Endothelial dysfunction is known to exaggerate coronary artery disease, sometimes leading to irreversible myocardial damage. In such cases, repetitive coronary revascularization including coronary artery bypass grafting is needed, which may cause a shortage of graft conduits. On the other hand, endothelial nitric oxide synthase (eNOS) is an attractive target of cardiovascular gene therapy. The vascular prostheses, of which the inner surfaces are covered with mesenchymal stem cells (MSCs) overexpressing eNOS, are expected to offer feasible effects of NO and angiogenic effects of MSCs on the native coronary arterial beds, as well as improvement of self-patency. Herein, we attempted to develop small caliber vascular prostheses generating the bioactive proteins. Also, we attempted to transduce eNOS cDNA into MSCs.
Methods and Results—
The MSCs were isolated from rat bone marrow and transduced with each adenovirus harboring rat eNOS cDNA and β-galactosidase (β-gal) (eNOS/MSCs and β-gal/MSCs). The β-gal/MSCs were impregnated into vascular prostheses, then the expressions of β-gal on the inner surfaces of them were evaluated by 5-bromo-4-chloro-3-indolyl β-
d
-galactoside staining. The NOS activity of eNOS/MSCs was assayed by monitoring the conversion of
3
H-arginine to
3
H-citrulline. The inner surfaces of the vascular prostheses were covered with MSCs expressing β-gal. The amount of the
3
H-citrulline increased, and eNOS/MSCs were determined to generate enzymatic activity of eNOS. This activity was completely inhibited by
N
G
-nitro-
l
-arginine methyl ester.
Conclusions—
The inner surface of expanded polytetrafluoroethylene vascular prostheses seeded with lacZ gene-transduced MSCs exhibited recombinant proteins. Development of eNOS/MSC-seeded vascular prostheses would promise much longer graft patency and vasculoprotective effects.
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Affiliation(s)
- Sachiko Kanki-Horimoto
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, 2-7 Daigakumachi Takatsuki, Osaka, 569-8686, Japan.
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Kanki-Horimoto S, Horimoto H, Mieno S, Kishida K, Watanabe F, Furuya E, Katsumata T. Synthetic vascular prosthesis impregnated with genetically modified bone marrow cells produced recombinant proteins. Artif Organs 2006; 29:815-9. [PMID: 16185343 DOI: 10.1111/j.1525-1594.2005.00134.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The aim of this study is to develop an experimental model of small caliber expanded polytetrafluoroethylene (ePTFE) vascular prostheses that produce recombinant proteins by seeding genetically modified bone marrow mesenchymal stem cells (MSC). Beta-galactosidase (beta-gal) cDNA was transduced into rat MSC mediated by an adenovirus vector. The cells were impregnated into the ePTFE vascular prostheses measuring 2 mm in internal diameter and 90 microm in fibril length, followed by 48 h of incubation. The expressions of beta-gal were determined by X-gal staining. The luminal surface of the ePTFE vascular prostheses was covered with the MSC expressing beta-gal. Most of the gene-transduced MSC spread along the fibers forming colonies. These results suggest that small caliber vascular prostheses, in which the inner surface was seeded by genetically modified MSC, produced recombinant proteins. This may be a preliminary model to autocrine functioning vascular prostheses.
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Affiliation(s)
- Sachiko Kanki-Horimoto
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Japan.
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Vara DS, Salacinski HJ, Kannan RY, Bordenave L, Hamilton G, Seifalian AM. Cardiovascular tissue engineering: state of the art. ACTA ACUST UNITED AC 2005; 53:599-612. [PMID: 16364812 DOI: 10.1016/j.patbio.2004.12.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2004] [Accepted: 12/03/2004] [Indexed: 11/18/2022]
Abstract
In patients requiring coronary or peripheral vascular bypass procedures, autogenous arterial or vein grafts remain as the conduit of choice even in the case of redo patients. It is in this class of redo patients that often natural tissue of suitable quality becomes unavailable; so that prosthetic material is then used. Prosthetic grafts are liable to fail due to graft occlusion caused by surface thrombogenicity and lack of elasticity. To prevent this, seeding of the graft lumen with endothelial cells has been undertaken and recent clinical studies have evidenced patency rates approaching reasonable vein grafts. Recent advances have also looked at developing a completely artificial biological graft engineered from the patient's cells with surface and viscoelastic properties similar to autogenous vessels. This review encompasses both endothelialisation of grafts and the construction of biological cardiovascular conduits.
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Affiliation(s)
- Dina S Vara
- Biomaterial and Tissue Engineering Centre (BTEC), University Department of Surgery, Royal Free and University College Medical School, University College London, Rowland Hill Street, London NW3 2PF, UK
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12
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Seifalian AM, Tiwari A, Hamilton G, Salacinski HJ. Improving the clinical patency of prosthetic vascular and coronary bypass grafts: the role of seeding and tissue engineering. Artif Organs 2002; 26:307-20. [PMID: 11952502 DOI: 10.1046/j.1525-1594.2002.06841.x] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In patients requiring coronary or peripheral vascular bypass procedures, autogenous vein is currently the conduit of choice. If this is unavailable, then a prosthetic material is used. Prosthetic graft is liable to fail due to occlusion of the graft. To prevent graft occlusion, seeding of the graft lumen with endothelial cells is undertaken. Recent advances have also looked at developing a completely artificial biological graft engineered from the patient's cells with properties similar to autogenous vessels. This review encompasses the developments in the two principal technologies used in developing hybrid coronary and peripheral vascular bypass grafts, that is, seeding and tissue engineering.
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Affiliation(s)
- Alexander M Seifalian
- Tissue Engineering Center, University Department of Surgery, Royal Free and University College Medical School, University College London and The Royal Free Hospital, U.K.
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13
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Yoneyama T, Sugihara KI, Ishihara K, Iwasaki Y, Nakabayashi N. The vascular prosthesis without pseudointima prepared by antithrombogenic phospholipid polymer. Biomaterials 2002; 23:1455-9. [PMID: 11829441 DOI: 10.1016/s0142-9612(01)00268-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
On the luminal surface of the common synthetic vascular prostheses, blood coagulation can occur and a thrombus membrane is formed when blood flow passes through it. The thrombus membrane should be organized according to the wound healing process and it becomes a pseudointima which could serve as a blood conduit. However, the small-diameter vascular prosthesis may be quickly occluded by the initial thrombus. Therefore, no clinically applicable small-diameter prostheses have been developed to date. 2-Methacrylovloxyethyl phosphoryleholine (MPC) polymers resemble the structure of an outer cell membrane similar to the fluid mosaic model and demonstrate excellent antithrombogenicity. The purpose of this study is to develop a clinically applicable small-diameter prosthesis based on the new concept of the MPC polymer. We prepared vascular prostheses (2mm ID) from polymer blend composed of segmented polyurethane and the MPC polymer. The prostheses were placed in rabbit carotid arteries. The luminal surface retrieved at eight weeks after implantation was clear without thrombus and pseudointima. We now realize that the vascular prosthesis having the MPC polymer can be applied as a small-diameter prosthesis because it functions without thrombus and pseudointima formation.
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Affiliation(s)
- Toshikazu Yoneyama
- The Second Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Japan
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14
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Karube N. Reply. Artif Organs 2002. [DOI: 10.1046/j.1525-1594.2002.00895.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Noishiki Y, Ichikawa Y, Kosuge T, Yamazaki I, Yamamoto K, Manabe T, Lu Y, Yamane Y. Introduction of tissue engineering concepts into the field of endovascular grafts: an attempt to solve endoleakage problems of endovascular grafts implanted in aortic aneurysms. Artif Organs 2001; 25:228-35. [PMID: 11284892 DOI: 10.1046/j.1525-1594.2001.025003228.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To solve endoleakage problems of endovascular prostheses inserted in aortic aneurysms, a concept originating from tissue engineering was proposed. We proposed that in order to accelerate the thrombus inside the aneurysm, three major factors for successful tissue engineering, i.e., appropriate cells, extracellular matrices, and growth factors, should be introduced into a space between the endovascular grafts and the aneurysm. As a simulation model in animals, two kinds of fabric vascular prostheses were used. One was a small graft used as an endovascular graft and another was a large graft as an envelope for the small graft, used as the aneurysm wall. Adipose tissue fragments with fresh blood coagula were injected between the two grafts. The control was a preparation without tissue fragments. Two months and a half after surgery, the test group showed complete connective tissue formation in the space between the two grafts, but in the control, brownish thrombus remained. From this experiment, we speculated that tissue fragment transplantation will accelerate connective tissue formation of the thrombus, and this complete organization of the thrombus might reduce endoleakage.
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Affiliation(s)
- Y Noishiki
- Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
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16
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Cardon A, Chakfé N, Thaveau F, Gagnon E, Hartung O, Aillet S, Kerdiles Y, Dion YM, Kretz JG, Doillon CJ. Sealing of polyester prostheses with autologous fibrin glue and bone marrow. Ann Vasc Surg 2000; 14:543-52. [PMID: 11128447 DOI: 10.1007/s100169910102] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to develop a sealing technique for polyester prosthetic grafts able to promote healing and reduce intimal hyperplasia. The porcine experimental model was aortoiliac bypass with a 6-mm diameter knitted polyester prosthetic graft implanted for 14 and 90 days. Animals were divided into three groups according to sealing technique as follows: pre-clotting with blood (group I, n = 12), sealing with autologous fibrin glue (group II, n = 14), and sealing with autologous fibrin glue and bone marrow cells (group III, n = 16). Feasibility and quality of sealing were evaluated by scanning electron microscopy prior to implantation and by assessment of blood loss. After removal, prostheses were cut into three segments comprising the proximal anastomosis, midsection, and distal anastomosis. Pieces were fixed, embedded in paraffin, and serially sectioned for histologic study. Histological study focused on the degree of stenosis and hyperplasia of the neointima of each prosthesis. The results of this short-term study indicate that sealing of polyester vascular prosthetic grafts with autologous fibrin glue and bone marrow cells is effective in reducing intimal hyperplasia. However further study will be needed to assess long-term healing.
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Affiliation(s)
- A Cardon
- Vascular Surgery Department, Rennes University Hospital Center, France
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17
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Frechette E, Dion YM, Cardon A, Chakfé N, Doillon CJ. Fat- and bone marrow-impregnated small diameter PTFE grafts. Eur J Vasc Endovasc Surg 1999; 18:308-14. [PMID: 10550265 DOI: 10.1053/ejvs.1999.0877] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES to evaluate an alternative and simple technique which consists in impregnation of a synthetic prosthesis with either autogenic omental fat or bone marrow. These tissues have been selected based on previous works and because they contain multiple cellular and extracellular compounds with biological healing properties (i.e. angiogenesis, endothelialisation, etc.). DESIGN PTFE grafts of Group 1 were impregnated with fatty tissue, those of Group 2 with bone marrow and those of Group 3 served as controls. MATERIALS nine mongrel dogs divided among these three groups. PTFE grafts are 3 mm in diameter. METHODS in each animal, both iliac arteries were submitted to an end-to-side ilio-iliac bypass. At 3 months, pathology assessment was performed. RESULTS group 1: all grafts were thrombosed and intimal hyperplasia was found occluding the anastomotic sites. Group 2: 4/6 grafts were patent and their mid-portion presented a thin neointima which did not totally cover the anastomotic sites. Group 3: 2/5 grafts were patent and their mid-portion as well as the anastomotic sites were covered with neointima which was hyperplastic in some areas. CONCLUSIONS addition of bone marrow cells may contribute to improve the quality of the healing process.
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Affiliation(s)
- E Frechette
- Department of Surgery, Laval University, Ste Foy, QC, Canada
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19
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Fujita Y, Wu MH, Ishida A, Shi Q, Walker M, Hammond WP, Sauvage LR. Accelerated healing of Dacron grafts seeded by preclotting with autologous bone marrow blood. Ann Vasc Surg 1999; 13:402-12. [PMID: 10398737 DOI: 10.1007/s100169900275] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
> Studies have suggested that bone marrow-derived cells in the circulation may have the capacity and potential to endothelialize and heal vascular graft surfaces. We have investigated whether accelerated endothelialization could be achieved for Dacron grafts seeded by preclotting with bone marrow blood (BMB). Five 8 mm x 6 cm Dacron grafts seeded and preclotted with BMB and four controls preclotted with peripheral blood were implanted in the descending thoracic aorta (DTA) of mongrel dogs for 2 and 4 weeks. Two additional BMB DTA grafts were studied for 3 months. Five pairs of BMB and control grafts (4 mm x 6 cm) were bilaterally implanted into the carotids of dogs for 1 week and five pairs for 4 weeks. All grafts remained patent. BMB seeding/preclotting was a simple, effective method to accelerate early graft endothelialization without increasing thrombogenicity. Further studies are needed before clinical application can be recommended.
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Affiliation(s)
- Y Fujita
- The Hope Heart Institute, Seattle, WA 98122, USA
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Bone marrow transplantation in vascular prostheses. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 1998. [DOI: 10.1016/s0928-4931(98)00055-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Noishiki Y, Yamane Y, Okoshi T, Tomizawa Y, Satoh S. Choice, isolation, and preparation of cells for bioartificial vascular grafts. Artif Organs 1998; 22:50-62. [PMID: 9456227 DOI: 10.1046/j.1525-1594.1998.06068.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Preparation of cells and tissues for bioartificial vascular grafts is discussed from the viewpoint of tissue engineering. In general, a neointima is not formed on vascular prostheses except at the anastomotic sites. Graft surfaces do not heal and are covered with fresh thrombi for a long period of time after implantation. The delayed healing is, so to speak, an intractable ulcer of the vascular wall. To overcome this problem, we have developed a tissue fragment transplantation method. We consider that neointima formation of vascular prostheses after implantation is a product of tissue engineering in vivo. Therefore, 3 essential elements for tissue engineering, i.e., cells, extracellular matrices, and cytokines, are required for neointima formation. Synthetic vascular prostheses lack one or more of these elements. In this study we demonstrated a standard healing process of fabric vascular prostheses and an antithrombogenic polymer graft using animal models. Then we showed the tissue fragment transplantation method using venous tissues, adipose tissues, and bone marrow. This method provided the 3 essential elements to the prostheses. To allow these elements to be actively engaged in neointima formation, we treated cells and tissues as clumps without enzymatic digestion. We also took advantage of the in vivo environment. With the results we demonstrate our way of thinking in relation to bioartificial vascular grafts.
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Affiliation(s)
- Y Noishiki
- First Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
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Takahashi K. Adsorption of basic fibroblast growth factor onto Dacron vascular prosthesis and its biological efficacy. Artif Organs 1997; 21:1041-6. [PMID: 9288877 DOI: 10.1111/j.1525-1594.1997.tb00521.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Adsorption of basic fibroblast growth factor (bFGF) onto a plain fabric Dacron vascular prosthesis (Micron, InterVascular Co., Ltd., Clearwater, FL, U.S.A.) and its release properties from the graft were examined using labeled bFGF, and its biological efficacy was evaluated in an animal study. In an in vitro study, 6 pieces of a Dacron graft were soaked in [(125)I]-bFGF solution for 30 min. Then these pieces were soaked in 500 ml saline solution for 15 days, and the radioactivity of each piece was counted at various times. The initial amount of adsorbed bFGF was 2.48 ng/cm2. At 24 h, 41% of the adsorbed bFGF was released and 59% remained. On the third day 55% remained, on the seventh day 52%, and on the 15th day 50% remained on the Dacron surface. Using the atmospheric glow discharge (APG) plasma treatment to render hydrophilic properties, no significant difference between plasma-treated grafts and non-plasma-treated grafts regarding the adsorption of bFGF was observed. In an in vivo study, 6 Dacron pieces adsorbed with bFGF were implanted in the subcutaneous layer of 2 dogs and removed 5 days after implantation. Six Dacron pieces without bFGF were also implanted as a control into the 2 dogs. Fibroblast migration with capillary ingrowth was observed in the specimens with bFGF compared to the controls. These results indicate that the simple adsorption of bFGF onto Dacron fabric is a useful method for the acceleration of host cell migration and capillary ingrowth into Dacron fabric vascular prostheses.
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Affiliation(s)
- K Takahashi
- First Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan
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Bouaziz A, Richert A, Caprani A. Vascular endothelial cell responses to different electrically charged poly(vinylidene fluoride) supports under static and oscillating flow conditions. Biomaterials 1997; 18:107-12. [PMID: 9022957 DOI: 10.1016/s0142-9612(96)00114-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We investigated the effect of electrically charged surface copolymers on endothelialization of four types of poly(vinylidene fluoride) (PVDF) copolymer surface films with different electrical characteristics. PVDF films without a surface charge, with a remanent surface (5 and 7 microC) and with piezoelectric characteristics were studied through the secretion by an endothelial cell (EC) line culture, under static and oscillating flow conditions of prostacyclin (PGI2) and thromboxane (TXA2), two metabolites which have directly opposing actions on platelet function. The surface electrical properties of PVDF are suitable for promoting cell adhesion. Secretion of thrombomodulatory mediators varied, depending on the surface electrical charge and on the molecular structure of the PVDF substrate. Under static conditions the ECs respond to the substrates by a similar increase of PGI2. Under oscillating flow conditions, the ratio of PGI2 to TXA2 is higher with the piezoelectric PVDF film. The piezoelectricity generated from shear stress along the entire length of the fibres may be appropriate in vivo to keep the [PGI2]/[TXA2] ratio at a level which could counteract the build-up of surface deposits which could be at the origin of thrombosis.
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Affiliation(s)
- A Bouaziz
- Laboratoire de Biorheologie et d'Hydrodynamique Physico-Chimique, Université Paris VII, CNRS URA 343, France
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Noishiki Y, Tomizawa Y, Yamane Y, Matsumoto A. Autocrine angiogenic vascular prosthesis with bone marrow transplantation. Nat Med 1996; 2:90-3. [PMID: 8564850 DOI: 10.1038/nm0196-90] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Synthetic vascular prostheses are foreign bodies, so that blood coagulation can occur on their luminal surfaces, causing graft occlusion very frequently in prostheses of small diameter. A vascular prosthesis needs angiogenesis for endothelialization of the luminal surface, as endothelial cells have natural and permanent antithrombogenic properties. To induce capillary growth into the graft, we developed a method of transplanting bone marrow cells, which are primitive, strong enough to survive, and create blood cells, resulting in the inducement of capillary growth. In an animal experiment, marrow cells were infiltrated into the walls of long-fibril expanded polytetrafluoroethylene (ePTFE) vascular grafts. The grafts were implanted in the abdominal aortic position of 24 dogs autologously. Marrow cells survived and continued exogenous hemopoiesis for up to six months and were immunohistochemically reactive to basic fibroblast growth factor (bFGF). All the grafts older than three weeks had complete endothelialization and maintained their patency. Twenty grafts without bone marrow were implanted as controls. Endothelialization was present at anastomotic sites, but other areas were covered with fresh thrombi. Four out of seven control grafts were patent with endothelial cell lining at six months, but three were occluded and one of the four grafts was still covered with a thrombus layer. Bone marrow with its unique native properties produced autocrine angiogenicity in the graft.
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Affiliation(s)
- Y Noishiki
- First Department of Surgery, Yokohama City University School of Medicine, Japan
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