Vascular Tissue Engineering: Polymers and Methodologies for Small Caliber Vascular Grafts

Abstract

Cardiovascular disease is the most common cause of death in the world. In severe cases, replacement or revascularization using vascular grafts are the treatment options. While several synthetic vascular grafts are clinically used with common approval for medium to large-caliber vessels, autologous vascular grafts are the only options clinically approved for small-caliber revascularizations. Autologous grafts have, however, some limitations in quantity and quality, and cause an invasiveness to patients when harvested. Therefore, the development of small-caliber synthetic vascular grafts (<5 mm) has been urged. Since small-caliber synthetic grafts made from the same materials as middle and large-caliber grafts have poor patency rates due to thrombus formation and intimal hyperplasia within the graft, newly innovative methodologies with vascular tissue engineering such as electrospinning, decellularization, lyophilization, and 3D printing, and novel polymers have been developed. This review article represents topics on the methodologies used in the development of scaffold-based vascular grafts and the polymers used in vitro and in vivo.

Systematic Review of Tissue-Engineered Vascular Grafts

“…Polylactic acid (PLA) is a polymer with a very similar structure and mechanical properties to PGA, but with a longer degradation time (Naito et al, 2011;Ong et al, 2017b). However, PLA exhibits a hydrophobic structure, which interferes in cell adhesion and proliferation (Leal et al, 2021).…”

Electrospun PCL-Based Vascular Grafts: In Vitro Tests

“…Vascular tissue engineering has emerged as one of the most promising approaches to producing mechanically competent vascular substitutes [14][15][16]. Main attention on tissue engineering technology is on extracellular matrix that support cell growth, proliferation, differentiation, function.…”

Commentary: Still searching for the Holy Grail 70 years later: I can see some light

“…Tissue-engineered vascular graft focuses on materials, mechanical characteristics, and surface optimization concerning endothelialization and tissue retraction, a complex biological process; interplay between scaffolds and cellular engrafting should determine ideal graft behavior. 8 A thick, irregular, unattached neointima of low quality in terms of compliance and flexibility, as well as subintimal fibrosis, seem to be at the root of the problem. 9 In this issue of the Journal, Tanaka and colleagues 10 present their experience with small-diameter silk fibroin vascular graft (3.5 mm) in a dog model.…”