Furukoshi Maya, Tatsumi Eisuke, Nakayama Yasuhide
Department of Regenerative Medicine and Tissue Engineering, Research Institute, National Cerebral and Cardiovascular Center, Suita, Japan.
Division of Cell Engineering, Graduate School of Chemical Sciences and Engineering, Hokkaido University, Sapporo, Japan.
J Vasc Access. 2020 May;21(3):314-321. doi: 10.1177/1129729819874318. Epub 2019 Sep 18.
The first choice of vascular access for hemodialysis is an autogenous arteriovenous fistula, because prosthetic arteriovenous grafts have a high probability of failure. In this study, Biotubes, in-body tissue architecture-induced autologous collagenous tubes, were evaluated for their potential use as vascular access grafts. Three animal implantation models were developed using beagle dogs, and the in vivo performance of Biotubes was observed after implantation in the acute phase as a pilot study.
Biotubes (internal diameter ca. 4.0 mm, length ca. 5.0 cm, and wall thickness ca. 0.7 mm) were prepared through subcutaneous embedding of specially designed molds in beagle dogs for 8 weeks. The Biotubes were then implanted between the common carotid artery and the jugular vein of beagles via three methods, including side-to-side (in) -end-to-end (out) as type 1 (n = 4), side-to-side (both) as type 2 (n = 4), and side-to-end (in) -end-to-side (out) as type 3 (n = 1 using a composite Biotube).
Although two cases in type 1 and 2 resulted in Biotube deformation, all cases were patent for 4 weeks and maintained a continuous turbulent flow. At 4 weeks after implantation, percutaneous puncture could be performed repeatedly without aneurysm formation or hemorrhage.
Within a short implantation period, with limited animal numbers, this proof-of-concept study showed that Biotubes may have a high potential for use in vascular access.
血液透析的血管通路首选自体动静脉内瘘,因为人工动静脉移植物有很高的失败概率。在本研究中,对生物管(体内组织结构诱导的自体胶原管)作为血管通路移植物的潜在用途进行了评估。使用比格犬建立了三种动物植入模型,并作为一项初步研究观察了生物管在急性期植入后的体内性能。
通过将特殊设计的模具皮下植入比格犬8周来制备生物管(内径约4.0毫米,长度约5.0厘米,壁厚约0.7毫米)。然后通过三种方法将生物管植入比格犬的颈总动脉和颈静脉之间,包括端侧(入)-端端(出)作为1型(n = 4),端端(双侧)作为2型(n = 4),以及端侧(入)-端侧(出)作为3型(n = 1,使用复合生物管)。
虽然1型和2型中有两例生物管出现变形,但所有病例在4周内均保持通畅,并维持持续的湍流。植入后4周,可反复进行经皮穿刺,无动脉瘤形成或出血。
在较短的植入期内,动物数量有限的情况下,这项概念验证研究表明生物管在血管通路应用方面可能具有很高的潜力。