Vascular Grafting Strategies in Coronary Intervention

Abstract

With the growing need for coronary revascularizations globally, several strategies to restore blood flow to the heart have been explored. Bypassing the atherosclerotic coronary arteries with autologous grafts, synthetic prostheses, and tissue-engineered vascular grafts continue to be evaluated in search of a readily available vascular graft with clinically acceptable outcomes. The development of such a vascular graft including tissue engineering approaches both in situ and in vitro is herein reviewed, facilitating a detailed comparison on the role of seeded cells in vascular graft patency.

Polytetrafluoroethylene topographies determine the adhesion, activation, and foreign body giant cell formation of macrophages

“…PTFE is a highly crystalline polymer with a hydrophobic, highly electronegative, and low friction surface, making it a suitable blood‐contacting biomaterial for applications such as vascular grafts . Although PTFE is used heavily in cardiovascular prostheses, a few complications still exist including anastomotic neointimal hyperplasia, thrombosis, and chronic inflammation …”

Bioresorbable Polymeric Scaffold in Cardiovascular Applications

“…In situations where stents cannot be deployed in arteries due to high SYNTAX score levels (≥34), coronary artery bypass graft (CABG) will be performed with a saphenous vein graft to reroute the flow of blood to the heart [5]. However, the suitability of the vein graft and other artificial conduits may not be ideal due to incompatible size and properties mismatch (such as compliance, stiffness) which can lead to thrombosis [6]. In cases where patients have experienced prior myocardial infarction (MI), the heart muscles are damaged and thinned [7].…”

Matching Static and Dynamic Compliance of Small‐Diameter Arteries, with Poly(lactide‐co‐caprolactone) Copolymers: In Vitro and In Vivo Studies

“…The neointima offers an ineffective blood contacting surface, prone to thrombosis and atherosclerosis. The “long‐term” NIH is triggered by either the immune system (as part of the foreign body response) or by the mismatch in mechanical properties between the graft and vasculature (referred to as compliance mismatch) 3,5–9. The latter is the reason of the failure of small‐diameter vessel replacements made of ePTFE or PET 3,5,7,10.…”

“…Poly‐ε‐caprolactone‐based polymers are frequently investigated as the material to fabricate small‐diameter vascular prostheses due to their biocompatibility and material properties 5,7,8,21,25,26. PLC 0:100 and its co‐polymers have been described as the polymers of potential for the 21st century, in regards to medical applications, which includes synthetic vascular prostheses 27.…”

“…The common fabrication technique used for vascular prostheses is electrospinning due to its uncomplicated mechanism and the generation of a fibrous structure of the scaffolds that resemble the extracellular matrix 5,7,8,21,25,26,37. In this study, we used an alternative method, dip‐coating, to fabricate conduit tubes from different PLC monomer ratios to test their suitability to act as a vascular prosthesis.…”