Эволюция сосудистых протезов: от древности до современной эпохи

Сосудистые протезы представляют собой неотъемлемый элемент реконструктивной сердечно-сосудистой хирургии. Актуальной задачей современной медицины по-прежнему остается поиск оптимальных пластических материалов и разработка новых образцов сосудистых трансплантатов. Исторический путь развития сосудистой хирургии охватывает переход от имплантаций первых экспериментальных трубчатых конструкций из стекла, кости и металлов к созданию высокотехнологичных синтетических, биологических и тканеинженерных графтов. В обзоре представлены ключевые этапы внедрения сосудистых протезов в клиническую практику, приведены результаты доклинических и клинических исследований, а также обозначены существующие ограничения и нерешенные вопросы. Акцентировано внимание на соответствие протезов биомеханическим свойствам нативных сосудов, их тромбои иммунорезистентности, а также устойчивости к инфекционным осложнениям. Отдельно рассмотрены современные образцы сосудистых протезов с анализом их характеристик, преимуществ и недостатков. Перспективы создания сосудистых трансплантатов малого диаметра связываются с развитием технологий трехмерной биопечати и созданием индивидуализированных графтов, максимально приближенных по структуре и функциональным свойствам к естественным тканям организма. Для подготовки обзора был проведен систематический поиск публикаций в международных электронных базах данных PubMed, Web of Science, Embase, а также в специализированных ресурсах Cochrane Library и отечественных электронных библиотечных системах. Поиск осуществлялся по ключевым словам: vascular grafts, prosthetic vascular implants, homografts, Dacron, PTFE, tissue engineering, small diameter vascular grafts. В результате поиска было выявлено 604 публикации. После анализа заголовков и аннотаций для дальнейшего рассмотрения были отобраны 412 источников. Из них исключены 338 статей ввиду несоответствия критериям включения (отсутствие релевантных исторических данных, наличие дублирующего материала). После окончательной оценки соответствия критериям включения в итоговый анализ вошли 72 статьи. Из них 5 публикаций использованы для подготовки раздела «Введение», а оставшиеся 67 – для написания основных разделов обзора.

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