Tissue Engineering of Blood Vessels

Abstract

The high occurrence of cardiovascular disease and increasing numbers of patients improve the need for vascular access. Stent implantation and bypass surgery are the current clinical treatments, but both of them have serious limitations. Thus, there is a significant need for a small-diameter (<6mm inner diameter) vascular graft. But how to construct an antithrombosis small-diameter vascular graft with long-term patency is key topic. Here, we summarized the exciting work that has been reported on tissue-engineering of blood vessels (TEBVs). Firstly, as seed cells for vascular grafts, a variety of stem cells were introduced. Then, this article covers the main approaches to scaffold construction of vascular graft: (1) acellular vascular tissues, (2) high molecular polymer scaffolds, (3) cellular sheets, and (4) natural biodegradable polymers. Cause the important role in the improvement of vascular grafts hemocompatibility and long-term patency, surface modification, and functionalization of scaffolds were detailed introduced. In addition, we described the current two TEBVs construction ways: in vitro and in vivo construction, and their pros and cons were also summarized. We specially introduced the using of host response to promote TEBVs remodeling in vivo like biomimetic endothelial cells and immunoregulation, which provide new perspective for TEBVs construction. What's more, many patients who need vascular graft therapy often have long-term basic diseases, so the TEBVs construction under high glucose pathological conditions and TEBVs neutralization in vivo were lucubrated and elaborated. At last, we summarized the current concerns that need to be addressed in TEBV construction and made prospects of complex tissues and organs vascularization. Continued progress in several fields to vascular tissue engineering is necessary before small-diameter TEBVs can achieve their full potential in clinic.