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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_980_Библиотеки_им_академика_М_И_Перельмана
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H. S. H. Boroojeni and H. Nokhbatolfoghahaei
capillary systems into arterioles, postcapillary venules, and venules allows prompt
vascularization and bone formation [81]. When compared to AVB, AV loop has
shown superior potential in originating capillary networks and prefabrication of
vascularized bone grafts. This may be due to accelerated angiogenesis, promoted
collateral sprouting of microvessels, and an upregulated expression of angiogenic
factors. Respectively, these underlying contributors can occur consequent to higher
levels of inammatory agents after anastomosis surgery, imposition of an increased
vascular shear ow on venous structure, and hypoxic matrix conditions [82]
(Fig.1).
Owing to its microsurgical basis, the AV loop can be performed at any body
region and, later on, translocated as a free ap. Therefore, higher potential for clinical application is associated with AV loops. Literature states that placement of the
arteriovenous stula in a porous chamber allows fusion of both extrinsic and intrinsic vessels. Based on this anastomosis phenomenon, an increased angiogenesis, and
more rapid vascularization mainly due to extrinsic vessels, and reduced prefabrication time, has been inspected [83].
The osteogenic abilities of AV loop are however highly dependent upon the properties of the BTE construct, itself. Slowly degradable scaffolds such as beta-TCP/
HA or processed cancellous bone matrix allografts are often better choice when
using AV loops, since rapidly degrading scaffolds have demonstrated lower bone
yield. However, an enhanced vascularization has been reported. In addition, during
clinical application of AV loops, molding most of the load-bearing bone grafts that
have been developed around an AV loop cannot be performed. The application of
AV loop invivo and in clinic has been extensively veried, and a faster vascularization rate has been reported with AV loop, when compared to AVB.However, its
clinical application has remained limited due to prolonged hospitalization that is
necessary for vascular sprouting to take place within the BTE constructs [84–87]
(Fig.7).
ab
Fig. 7 Vascular techniques for invivo bioreactor; (a) axial vessel bundle (AVB) model; (b) arte-
riovenous loop (AVL) model
Application ofBioreactors inOral andMaxillofacial Surgery
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