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.
Highlights
More than 550,000 surgical bypass procedures are performed annually in the UnitedStates for coronary artery disease and peripheral artery disease (PAD) [1]
They used a sheep model, which is considered to be more suitable for the quently, they used a sheep model, which is considered to be more suitable for the in in vivo testing of cardiovascular implants [39]. They had expectations of a high incidencevivo testing of cardiovascular implants. They hadtoexpectations of a high incidence of thrombosis in a sheep model; reduce the thrombogenicity of the of thrombosis in a sheep model; attempted to reduce the thrombogenicity of the PHBV/PCL-GFmix grafts by combining heparin and iloprost on the surface of the grafts
Electrospinning technology is often used to create grafts that take into account a varietyElectrospinning of important properties of bioabsorbable synthetic grafts, such as degradation rate, a technology is often used to create grafts that take into account variety of important properties of bioabsorbable synthetic grafts, such as degradation rate, response to high-pressure environments, and cell infiltration rate
Summary
More than 550,000 surgical bypass procedures are performed annually in the United. An estimated 80,000 patients are unable to undergo life-saving or limb-saving bypass graft surgery due to the inadequate availability of autologous vascular graft material [2]. Vessel harvesting increases operation times and patient complications, leading to graft fragility and increased risk of repeat surgery These risks have been addressed by prosthetic grafts, existing non-bioabsorbable options only work well in large caliber vessels and are a significant source of morbidity and mortality from graft-related complications such as infection, occlusion, and calcification [3,4,5].
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