Current Strategies for the Manufacture of Small Size Tissue Engineering Vascular Grafts.
Current Strategies for the Manufacture of Small Size Tissue Engineering Vascular Grafts.
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DOI：
10.3389/fbioe.2018.00041
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发表时间：
2018
影响因子：
5.7
通讯作者：
Madeddu P
中科院分区：
文献类型：
--
作者：
Carrabba M;Madeddu P
包括冠心病(CHD)和外周动脉疾病(PAD)在内的闭塞性动脉疾病是主要的死亡原因，预计到2030年，全球年死亡率将上升到2330万。目前的血管重建技术包括血管成形术、支架置入或外科旁路移植。自体血管，如隐静脉和胸廓内动脉，是小直径血管的黄金标准移植物。然而，它们需要侵入性的收获，而且往往无法获得。人造血管移植物是替代自体血管的一种方法。这些移植物在替换大中径动脉，如颈动脉或股总动脉方面显示出令人满意的长期效果，但当应用于小直径血管时，如冠状动脉和膝盖以下的动脉，通畅率较低。考虑到目前血管搭桥管道的局限性，一种能够在体内生长、重建和修复的组织工程血管移植物为未来血管外科提供了一种潜在的解决方案。在这里，我们回顾了过去几十年来研究小组一直在研究的创建TEVG的不同方法。我们将重点放在移植物制造过程中使用的技术，并将其归类为基于支架的方法(合成的、自然的或杂交的)或自组装的方法(细胞片、微组织聚集和生物打印)。此外，我们强调迄今为将这一新战略从替补席转变为床边所作的努力。
Occlusive arterial disease, including coronary heart disease (CHD) and peripheral arterial disease (PAD), is the main cause of death, with an annual mortality incidence predicted to rise to 23.3 million worldwide by 2030. Current revascularization techniques consist of angioplasty, placement of a stent, or surgical bypass grafting. Autologous vessels, such as the saphenous vein and internal thoracic artery, represent the gold standard grafts for small-diameter vessels. However, they require invasive harvesting and are often unavailable. Synthetic vascular grafts represent an alternative to autologous vessels. These grafts have shown satisfactory long-term results for replacement of large- and medium-diameter arteries, such as the carotid or common femoral artery, but have poor patency rates when applied to small-diameter vessels, such as coronary arteries and arteries below the knee. Considering the limitations of current vascular bypass conduits, a tissue-engineered vascular graft (TEVG) with the ability to grow, remodel, and repair in vivo presents a potential solution for the future of vascular surgery. Here, we review the different methods that research groups have been investigating to create TEVGs in the last decades. We focus on the techniques employed in the manufacturing process of the grafts and categorize the approaches as scaffold-based (synthetic, natural, or hybrid) or self-assembled (cell-sheet, microtissue aggregation and bioprinting). Moreover, we highlight the attempts made so far to translate this new strategy from the bench to the bedside.
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