Small-diameter (less than 6 mm in diameter) vascular grafts are highly desirable due to the large demand for surgical revascularization; however, there are no available artifi cial grafts. Vascular grafts of 1.5 mm diameter prepared by...
moreSmall-diameter (less than 6 mm in diameter) vascular grafts are highly desirable due to the large demand for surgical revascularization; however, there are no available artifi cial grafts. Vascular grafts of 1.5 mm diameter prepared by our group with silk fi broin fi ber have been proved to be excellent grafts with remarkably high patency and remodeling, based on rat implantation experiment (Enomoto et al., 2010). In this study, a silk fi broin vascular graft with 3 mm diameter which can be used for the coronary arteries or lower extremity arteries is prepared with a double-raschel knitted Bombyx mori silk fi ber tube coated with B. mori silk fi broin sponge. Here the silk sponge is prepared from an aqueous solution of the silk fi broin and poly(ethylene) glycol diglycidyl ether as porogen. Suffi cient strength, proper elasticity, and protection from loose ends in the implantation process are obtained for the silk fi broin graft; low water permeability and relatively large compliance are also attained. These excellent physical properties make silk fi broin grafts suitable to be implanted in a canine model. grafts larger than 6 mm in internal diameter (ID). [ 1 ] Specifi cally, the patencies of e-PTFE and Dacron grafts (6 mm ID) were 26-46% and 42-62%, respectively, at 5 years follow-up time. [ 2 ] However, grafts with smaller than 6 mm ID fail early due to thrombus formations and intimal hyperplasia. [ 3 , 4 ] Animal studies have shown only a 20-25% patency rate with 1 mm diameter PTFE grafts, while all vein grafts in a similar size remained patent. [ 5,6 ] Silk fi broin (SF) fi ber from Bombyx mori has a long history of use in textiles. SF fi ber also has a long history of use as a suture material because of its high strength and toughness. [ 7 ] Moreover, SF has been reported to have many inherent superior properties as a biomaterial in terms of mechanical properties, environmental stability, biocompatibility, low immunogenicity, and biodegradability; [ 8-11 ] therefore, many applications of SF biomaterials have been examined. [ 12-16 ] SF has been previously studied as biomaterial substrates for cell growth related to tissue engineering. Electrospun and porous silk composite scaffolds have been used for ingrowth of human mesenchymal stem cells (hMSCs) to osteogenic tissue formation in vitro. Both scaffolds supported high calcium deposition and cell differentiation. [ 16-19 ] In our previous studies, [ 20,21 ] we prepared SF grafts by braiding, fl attening, and winding the SF fi bers onto a cylindrical polymer tube followed by coating with an SF aqueous solution. The grafts, which are 1.5 mm in ID and 10 mm in length, were implanted into rat abdominal aorta. An excellent patency (85.1%; n = 27) at 1 year after grafting with SF fi bers was obtained. This patency rate was remarkably higher than that of e-PTFE grafts (30%; n = 10, p < 0.01). Endothelial cells and smooth muscle cells were organized early on the inner layer of the SF graft. Sirius-red staining revealed that the collagen content of fi broin grafts signifi cantly increased 1 year after implantation, with a decrease in SF content. [ 20 ] However, this graft has some problems when used with larger diameter (3 mm) for the coronary arteries or lower extremity arteries because of its relatively weak strength, lack of elasticity, and tendency for the end of the graft to become loose during the implantation process, which are not very serious problems in