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Vascular Grafts

Vascular disease is the principle cause of death in the Western World. Up to 90-95% of arterial diseases are caused by arteriosclerosis, which results in narrowing (stenosis) or complete blockage of the arteries.

Such diseases with a particularly high incidence include coronary heart disease, arterial occlusive disease of the pelvic and lower limb arteries, narrowing of the carotid arteries, and the narrowing of the renal and splanchnic arteries.

When a blocked artery cannot be replaced by a vein, as a result of previous surgical vein harvest, a synthetic graft is usually employed. However, a synthetic artery is not accepted by the body as well as a vein, and it can be quickly blocked again. As a result, there is a need to develop a novel vascular graft prosthesis.

The concept of the “Vascular Composite Graft” allows for the synthesis of a living, autologous graft through the use of a highly porous textile structure.

 

Fig. 1: Principle of Vascular Composite Grafts

According to the principle of tissue engineering, the Vascular Composite Graft is formed using a customised process to mold a composite of cells (myofibroblasts), fibrinogen and a macroporous textile structure.

Fig. 2: (A) macroporous mesh, (B) macroporous mesh closeup view, (C) with fibringel and cells seeded mesh, (D) mold, (E) lumen of vascular graft

The vascular graft is subsequently cultivated in a bioreactor system developed in our group, under physiological flow and pressure conditions.

Fig. 3: Bioreactorsystem

The concept of the Vascular Composite Graft allows the manufacture of a structurally stable, small calibre, implantable vascular prosthesis.

Within the scope of the EU-STREProject BioSys , further advances of the method are being undertaken through the use of an intelligent, biodegradable PLA fibre, which replaces the hitherto applied non-degradable PVDF fibre.

 

Fig. 4: Results of the feasibility study in the carotid artery position of adult sheep. (A) At the time point of implantation, (B) after 6 month in situ and (C) after explantation and longitudinal incision. (D) GoreTex™ control on the contralateral side demonstrates already a significant stenosis.

The Vascular Composite Graft demonstrates, for the first time, the successful production and mid-term application of an autologous, fibrin-based small-caliber vascular graft in the arterial circulation, and highlights the potential for the creation of completely autologous implantable arterial grafts in a number of settings.

Koch S, Flanagan TC, Sachweh JS, Tanios F, Schnoering H, Deichmann T, Ellä V, Kellomäki M, Gronloh N, Gries T, Tolba R, Schmitz-Rode T and Jockenhoevel S. Fibrin-polylactide-based tissue-engineered vascular graft in the arterial circulation. Biomaterials 2010 Mar 19 Epub 2010 Mar 20 PubMed

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