title: Effects of Fabrication on Early Patency and Regeneration of Small Intestinal Submucosa Vascular Grafts.
abstract: Small intestinal submucosa grafts for vascular regeneration have produced variable patency (0-100%) that has been concurrent with variability in fabrication techniques. We hypothesized that 1) preservation (P) or removal (R) of the stratum compactum layer of the intestine and 2) a dehydrated (D) or hydrated (H) state of the graft, affect early patency and tissue regeneration. We combined both parameters through a 2(2) factorial experimental design into four groups (PD, RD, PH, RH), and compared them in an in vivo early response predictive model (swine, ID 4.5 mm, 7d, n = 4). Patency, thrombogenicity, vascularization, fibroblast infiltration, macrophage polarization profile, endothelialization, and biaxial mechanics were assessed. PD grafts remained patent (4/4) but had scarce vascularization and fibroblast infiltration. RD and RH had extensive vascularization and fibroblast infiltration, however, RD had sustained patency (4/4) and the highest number of regeneration-associated phenotype macrophages (M2), whereas RH had lower patency (3/4) and less M2 macrophages. PH had a modest cellular infiltration, but the lowest patency (2/4) and a dominant adverse macrophage phenotype. Elasticity of R grafts evolved toward that of native carotids (particularly RD), while P grafts kept their initial stiffness. We concluded that fabrication parameters drastically affected early patency and regeneration, with RD providing the best results.
authors.affiliation: From the *Department of Biomedical Engineering, Universidad de los Andes, Bogota, Colombia; †CEIBA Complex Systems Research Center, Bogota, Colombia; ‡Department of Cardiovascular Surgery, Fundación Cardioinfantil - Instituto de Cardiología, Bogota, Colombia; §School of Medicine, Universidad de los Andes, Bogota, Colombia; ¶Laboratory and Department of Pathology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia; and ‖Department of Research, Fundación Cardioinfantil - Instituto de Cardiología, Bogota, Colombia.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Sánchez-Palencia
authors.forename: Javier
authors.initials: J
authors.lastname: Navarro
authors.forename: Juan C
authors.initials: JC
authors.lastname: Araque
authors.forename: Juan B
authors.initials: JB
authors.lastname: Umaña
authors.forename: Alvaro F
authors.initials: AF
authors.lastname: Guerrero
authors.forename: Lina M
authors.initials: LM
authors.lastname: Quijano
authors.forename: Rocío D P
authors.initials: RD
authors.lastname: López
authors.forename: Néstor F
authors.initials: NF
authors.lastname: Sandoval
authors.forename: Juan C
authors.initials: JC
authors.lastname: Briceno
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D001808:Blood Vessels / Q000502:physiology*; D002339:Carotid Arteries / Q000502:physiology* / Q000601:surgery; D006083:Graft Occlusion, Vascular; D007413:Intestinal Mucosa / Q000502:physiology / Q000637:transplantation; D007583:Jejunum / Q000502:physiology* / Q000637:transplantation; D023421:Models, Animal; D012038:Regeneration; D013552:Swine; D014654:Vascular Patency