小口径人工血管の開発の現状とマイクロサージャリー領域への応用可能性

抄録

　There is a growing demand for small-diameter artificial vascular grafts to replace damaged vessels. Due to poor patency rates due to the small diameter and susceptibility to bacterial colonization among current synthetic vascular grafts, a tissue-engineered vascular graft (TEVG) presents a potential solution for the future of vascular surgery. This article describes the history of vascular replacement and TEVGs. The various approaches to generate TEVGs, including cell-based, scaffold-based, and luminal functionalization methods, are described, along with the results of clinical trials. In addition, focusing on the field of microvascular surgery, whether TEVGs can be an alternative to autologous blood vessels and be considered as the gold standard for microvascular reconstruction or replacement is discussed. Recently, we developed an acellular small-diameter TEVG that was modified with the integrin α4β1 ligand, REDV. The luminal modification had high patency rates in both the decellularized ostrich-carotid artery (2-4-mm diameter) and decellularized rat tail artery (0.6-mm diameter) in animal models. The potential application of TEVG to microsurgery is also discussed.