title: Vascular replacement using a layered elastin-collagen vascular graft in a porcine model: one week patency versus one month occlusion.
abstract: A persistent clinical demand exists for a suitable arterial prosthesis. In this study, a vascular conduit mimicking the native 3-layered artery, and constructed from the extracellular matrix proteins type I collagen and elastin, was evaluated for its performance as a blood vessel equivalent. A tubular 3-layered graft (elastin-collagen-collagen) was prepared using highly purified type I collagen fibrils and elastin fibers, resembling the 3-layered native blood vessel architecture. The vascular graft was crosslinked and heparinised (37 ± 4 μg heparin/mg graft), and evaluated as a vascular graft using a porcine bilateral iliac artery model. An intra-animal comparison with clinically-used heparinised ePTFE (Propaten®) was made. Analyses included biochemical characterization, duplex scanning, (immuno)histochemistry and scanning electron microscopy. The tubular graft was easy to handle with adequate suturability. Implantation resulted in pulsating grafts without leakage. One week after implantation, both ePTFE and the natural acellular graft had 100% patencies on duplex scanning. Grafts were partially endothelialised (Von Willebrand-positive endothelium with a laminin-positive basal membrane layer). After one month, layered thrombi were found in the natural (4/4) and ePTFE graft (1/4), resulting in occlusion which in case of the natural graft is likely due to the porosity of the inner elastin layer. In vivo application of a molecularly-defined tubular graft, based on nature's matrix proteins, for vascular surgery is feasible.
authors.affiliation: a Department of Biochemistry ; NCMLS; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.|b Department of Urology ; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: M J W
authors.initials: MJ
authors.lastname: Koens
authors.affiliation: c Department of Surgery ; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: Krasznai
authors.affiliation: d Central Animal Laboratory; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: A E J
authors.initials: AE
authors.lastname: Hanssen
authors.affiliation: c Department of Surgery ; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Hendriks
authors.affiliation: c Department of Surgery ; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Praster
authors.affiliation: a Department of Biochemistry ; NCMLS; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: W F
authors.initials: WF
authors.lastname: Daamen
authors.affiliation: c Department of Surgery ; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: van der Vliet
authors.affiliation: a Department of Biochemistry ; NCMLS; Radboud University Medical Centre ; Nijmegen , HB , The Netherlands.
authors.forename: T H
authors.initials: TH
authors.lastname: van Kuppevelt
mesh_terms: D000818:Animals; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000503:physiopathology*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D003094:Collagen / Q000737:chemistry*; D004549:Elastin / Q000737:chemistry*; D019544:Equipment Failure Analysis; D016326:Extracellular Matrix Proteins / Q000737:chemistry; D005260:Female; D006084:Graft Rejection; D007083:Iliac Artery / Q000502:physiology* / Q000601:surgery; D011474:Prosthesis Design; D013552:Swine; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000295:instrumentation; D014654:Vascular Patency / Q000502:physiology*
chemical_list: D016326:Extracellular Matrix Proteins; D003094:Collagen; D004549:Elastin
keywords: Collagen; animal model; bypass surgery; elastin; scaffold; tissue engineering; vascular conduit