Development of small-diameter vascular grafts.

Abstract

Cardiovascular disease, including coronary artery and peripheral vascular pathologies, is the leading cause of mortality in the United States and Western countries. There is a pressing need to develop small-diameter vascular vessels for bypass surgery and other vascular reconstructive procedures. Tissue engineering offers the prospect of being able to meet the demand for replacement of diseased vessels. Significant advances have been made in recent studies and provide confidence that success is attainable. For instance, a completely cellular approach culturing cells into tissue sheets and wrapping these layers was able to form a layered cellular vascular graft with impressive strength. In our experiments, decellularization and heparin immobilization grafts from porcine tissues implanted in a canine model could be repopulated from the host cells, indicating the grafts' potential to develop into living tissues that can adapt and respond to changes in the body. This review summarizes the current status of vascular grafts used clinically, updates the most recent developments on vascular tissue engineering, and discusses the challenges for the future.