Universität zu Köln

Weber, Carolyn, Reinhardt, Stefanie, Eghbalzadeh, Kaveh, Wacker, Max, Guschlbauer, Maria, Maul, Alexandra, Sterner-Kock, Anja, Wahlers, Thorsten, Wippermann, Jens and Scherner, Max (2018). Patency and in vivo compatibility of bacterial nanocellulose grafts as small-diameter vascular substitute. J. Vasc. Surg., 68 (6). S. 177S - 188. NEW YORK: MOSBY-ELSEVIER. ISSN 0741-5214

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Abstract

Objective: Despite the clinical success of large-diameter vascular grafts, synthetic grafts in small-diameter vessels are of limited use because of their poor patency rates. Previous experiments of our group provided evidence for good biocompatibility of bacterial nanocellulose (BNC) as a small-vessel graft in the carotid artery in sheep. However, the patency rate of our first-generation tubes after 3 months was only 50%. To advance our concept, we now used modified second-generation tubes with diminished wall thickness and a smoother inner surface to reduce the thrombogenic potential. The aim was to investigate mechanical characteristics of modified second-generation BNC tubes, to evaluate in vivo performance and biocompatibility, and to analyze patency rates. Methods: We replaced the right carotid artery of 23 sheep with second-generation BNC tubes. Compared with our first-generation tubes, tubes were modified with different surface properties and diminished wall thickness (inner diameter, 4.0-5.0 mm; wall thickness, 1.0-2.5 mm; length, 100 mm) to generate a smoother inner surface with reduced thrombogenic potential and a more porous outer zone, allowing easier cell immigration. Results: At the end of the investigational period, BNC tubes were explanted and grafts were processed for histopathologic analysis. Histologic analysis revealed no acute signs of foreign body reaction such as immigration of giant cells or other acute inflammatory reaction and therefore provided evidence for good biocompatibility of the second-generation tubes. However, all grafts of the sheep without antiplatelet therapy were occluded after 9 months, whereas grafts in sheep receiving dual platelet inhibition showed a patency rate of 67% (six of nine grafts). Further modified grafts revealed a patency rate of 80% (four of five grafts remained open). Conclusions: Patency rates of the second-generation tubes could be substantially improved compared with our first-generation tubes. However, poor patency rates of tissue-engineered blood vessels still limit their use in clinical studies. Further efforts in terms of in vitro and in vivo studies are essential to improve grafts of BNC. (J Vasc Surg 2018;68:177S-87S.) Clinical Relevance: Despite the clinical success of large-diameter vascular grafts, synthetic grafts in small-diameter vessels (<6 mm) are rarely used because of poor patency rates, which limit their application in peripheral and coronary vascular bypass graft procedures. Hence, nonthrombogenic materials with good biocompatibility and favorable mechanical characteristics that mimic the compliance and strength of the native vessels are required. One promising concept is the use of the hydrogel bacterial nanocellulose designed in tubular shape.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Reinhardt, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Wacker, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Guschlbauer, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Maul, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterner-Kock, Anja UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164051
DOI:	10.1016/j.jvs.2017.09.038
Journal or Publication Title:	J. Vasc. Surg.
Volume:	68
Number:	6
Page Range:	S. 177S - 188
Date:	2018
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	0741-5214
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language KNEE FEMOROPOPLITEAL BYPASS; SAPHENOUS-VEIN; BLOOD-VESSELS; MECHANICAL-PROPERTIES; CELLULOSE; BIOCOMPATIBILITY; CELLS; PTFE; HEAL Multiple languages Surgery; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16405