Inside-out技术构建的组织工程血管在猪CABG模型中的通畅率及功能研究

组织工程制备的小口径人工血管有望为外科治疗冠心病提供新的旁路移植血管。人工血管的内皮化程度是影响其远期通畅性的关键因素，目前普遍采用的内皮化技术存在效率较低、细胞覆盖不均匀等问题。本研究原创性地提出Inside-out技术，将脱细胞动脉支架内膜翻转至管腔外，提升细胞种植率和细胞覆盖均匀度。从而显著提高人工血管的内皮化程度，我们前期研究发现，其作为移植血管在外周血管置换中获得了满意的通畅率。本研究为检验经Inside-out技术构建的人工血管在冠状动脉旁路移植（CABG）中的应用潜力，将建立猪的不停跳CABG模型，观察该人工血管的远期（1年）通畅率和血管内膜变化，并探索其机制。本课题将通过更接近临床的模型检验组织工程血管的通畅率和功能，为组织工程学中的内皮化不充分导致远期通畅率低下这一关键问题提供新的技术方案，为推动血管组织工程向临床应用转化提供新思路。

Tissue-engineered small-diameter vascular grafts (TEVG) provide a promising alternative for surgical treatment of coronary heart disease. The intraluminal endothelialization is a real technological hurdle in vascular tissue engineering related to the difficulty to obtain a homogeneous intima layer resistant to blood flow. This study presents an innovative inside-out method to cellularize the lumen of human small-diameter vascular grafts. In our previous studies, TEVG constructed with the inside-out technique are completely and homogeneously covered by human mesenchymal stem cells, and all TEVG treated with the inside-out method remain patent in peripheral artery replacement models. This study aims to further evaluate the patency and function of these TEVG in a coronary artery bypass grafting model in big animals, which would provide straightforward evidence for the applicational potential of TEVG in a circumstance closer to clinical reality. The underlying mechanism of the improved patency will also be investigated in this study on the cellular and molecular level. The inside-out method, as an innovative approach, would be a new resolution to the difficulty of obtaining completely endothelialized TEVG, which is crucial for their long term patency.