Systematic Review of Tissue-Engineered Vascular Grafts.

David Durán-Rey,Juan A Sánchez-Margallo,Francisco M Sánchez-Margallo,Verónica Crisóstomo

doi:10.3389/fbioe.2021.771400

Abstract

Pathologies related to the cardiovascular system are the leading causes of death worldwide. One of the main treatments is conventional surgery with autologous transplants. Although donor grafts are often unavailable, tissue-engineered vascular grafts (TEVGs) show promise for clinical treatments. A systematic review of the recent scientific literature was performed using PubMed (Medline) and Web of Science databases to provide an overview of the state-of-the-art in TEVG development. The use of TEVG in human patients remains quite restricted owing to the presence of vascular stenosis, existence of thrombi, and poor graft patency. A total of 92 original articles involving human patients and animal models were analyzed. A meta-analysis of the influence of the vascular graft diameter on the occurrence of thrombosis and graft patency was performed for the different models analyzed. Although there is no ideal animal model for TEVG research, the murine model is the most extensively used. Hybrid grafting, electrospinning, and cell seeding are currently the most promising technologies. The results showed that there is a tendency for thrombosis and non-patency in small-diameter grafts. TEVGs are under constant development, and research is oriented towards the search for safe devices.

Highlights

Cardiovascular diseases (CVDs) are the main cause of death globally (World Health Organization, 2020)
There was a correlation between the non-patency of the vascular graft and the onset of thrombosis during surgery in the nonhuman primate model
The results showed that the control group had no patency owing to the appearance of thrombosis, whereas in the experimental group, the graft patency was maintained during the 6months study

Summary

Introduction

Cardiovascular diseases (CVDs) are the main cause of death globally (World Health Organization, 2020). The narrowing or blockage of blood vessels are disorders that induce reduced blood flow and tissue damage due to poor nutrient provision (Pashneh-Tala et al, 2015). Annual mortality from CVDs is expected to increase to 23.3 million people worldwide by 2030 (Mathers and Loncar, 2006). A change in lifestyle, including a healthy and balanced diet, could be adequate to prevent CVD. Surgical and pharmaceutical intervention are often required (Abdulhannan et al, 2012). Endovascular surgeries, including angioplasty, can be used to mitigate these diseases (Pashneh-Tala et al, 2015). Conventional surgeries using autologous saphenous veins, radial arteries, or internal mammary artery transplants—which create a bypass to restore normal blood flow—are often required (Row et al, 2017). Many studies have been conducted aiming to treat vascular disorders through the use of vascular grafts, and their efficacy in animal models and human patients has been demonstrated

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