Conception et validation d'un substitut vasculaire naturel, fonctionnalisé par un film multicouche de polyélectrolytes et cellularisé par un endothelium autologue orienté

Abstract : Vascular diseases with their high rate of mortality and morbidity belong to the pathologies involving important socio-economic factors for health system. Despite the advantages of autografts, the limited availability of autologous vessels has led to the development of synthetic prostheses. However, their high thrombogenic surface limits their use as small calibre vascular substitutes (< 6 mm). To prevent narrowing of small diameter vascular grafts, the reconstruction of a luminal surface close to the native endothelium is essential. However, the retention of the neo-endothelium subjected to shear stress is poor on the coatings currently available. In this work, we developed a small calibre endothelialized vascular substitute thanks to three elements: 1) a natural matrix prepared from umbilical artery, 2) an innovative coating based on the polyelectrolytes multilayer film (PEM) (PAH-PSS)3-PAH, and 3) used for cell culture of mature or progenitor endothelial cells. In vitro studies have shown that the formation, the retention under shear stress and the endothelial function of the neoendothelium on the luminal surface were improved by PEM film. The anastomosis of this substitute on rabbits has shown that the specifications essential to small calibre vascular grafts were reached, mainly in terms of permeability and diameter but also of resistance to suture and infections. In conclusion, PEM films helped us to develop a small diameter vascular substitute with long term patency.
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Estelle Paternotte. Conception et validation d'un substitut vasculaire naturel, fonctionnalisé par un film multicouche de polyélectrolytes et cellularisé par un endothelium autologue orienté. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2010. Français. ⟨NNT : 2010NAN10105⟩. ⟨tel-01748646⟩

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