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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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Antonova LV, Mironov AV, Yuzhalin AE, Krivkina EO, Shabaev AR, Rezvova MA, Tkachenko VO, Khanova MY, Sergeeva TY, Krutitskiy SS, Barbarash LS. A Brief Report on an Implantation of Small-Caliber Biodegradable Vascular Grafts in a Carotid Artery of the Sheep. Pharmaceuticals (Basel) 2020; 13:E101. [PMID: 32455730 PMCID: PMC7280958 DOI: 10.3390/ph13050101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 12/31/2022] Open
Abstract
The development of novel biodegradable vascular grafts of a small diameter (<6 mm) is an unmet clinical need for patients requiring arterial replacement. Here we performed a pre-clinical study of new small-caliber biodegradable vascular grafts using a sheep model of carotid artery implantation. The 4 mm diameter vascular grafts were manufactured using a mix of polyhydroxybutyrate/valerate and polycaprolactone supplemented with growth factors VEGF, bFGF and SDF-1α (PHBV/PCL-GFmix) and additionally modified by a polymer hydrogel coating with incorporation of drugs heparin and iloprost (PHBV/PCL-GFmixHep/Ilo). Animals with carotid artery autograft implantation and those implanted with clinically used GORE-TEX® grafts were used as control groups. We observed that 24 h following surgery, animals with carotid artery autograft implantation showed 87.5% patency, while all the PHBV/PCL-GFmix and GORE-TEX® grafts displayed thrombosis. PHBV/PCL-GFmixHep/Ilo grafts demonstrated 62.5% patency 24 h following surgery and it had remained at 50% 1 year post-operation. All the PHBV/PCL grafts completely degraded less than 1 year following surgery and were replaced by de novo vasculature without evidence of calcification. On the other hand, GORE-TEX® grafts displayed substantial amounts of calcium deposits throughout graft tissues. Thus, here we report a potential clinical usefulness of PHBV/PCL grafts upon their additional modification by growth factors and drugs to promote endothelialization and reduce thrombogenicity.
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Affiliation(s)
- Larisa V. Antonova
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Andrey V. Mironov
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Arseniy E. Yuzhalin
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Evgeniya O. Krivkina
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Amin R. Shabaev
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Maria A. Rezvova
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Vadim O. Tkachenko
- Budker Institute of Nuclear Physics SB RAS, 11 akademika Lavrentieva Ave, Novosibirsk 630090, Russia;
| | - Mariam Yu. Khanova
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Tatiana Yu. Sergeeva
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Sergei S. Krutitskiy
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
| | - Leonid S. Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo 650002, Russia; (L.V.A.); (A.V.M.); (E.O.K.); (A.R.S.); (M.A.R.); (M.Y.K.); (T.Y.S.); (S.S.K.); (L.S.B.)
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