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.
Highlights
CLINICAL NEED FOR VASCULAR GRAFTS Of cardiovascular diseases, coronary artery disease (CAD) is the leading cause of death in the world, accounting for more than seven million deaths annually (Gaziano et al, 2010)
The vein graft is subject to increased pressures as well as shear and pulsatile forces associated with arterial blood flow, resulting in a phenotypic switch of the smooth muscle cells (SMCs) from the contractile to the synthetic phenotype (Shukla and Jeremy, 2012)
An improvement in outcome and patency of the supported vein grafts was observed, the study was terminated at 3 months, which may have been insufficient to evaluate this medical device for the prevention of long-term occlusion due to hyperplasia
Summary
CLINICAL NEED FOR VASCULAR GRAFTS Of cardiovascular diseases, coronary artery disease (CAD) is the leading cause of death in the world, accounting for more than seven million deaths annually (Gaziano et al, 2010). This data does not suggest that intimal hyperplasia may be reduced due to decreased SMC with the heparin immobilized POC-coated ePTFE grafts, Hoshi et al did demonstrate the combined benefit of anti-coagulant therapeutic delivery and improved endothelialization.
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