Blood vessel replacement: 50 years of development and tissue engineering paradigms in vascular surgery

• Published in: Physiological research Vol. 58 Suppl 2; pp. S119 - S140
• Main Authors: Chlupáč, J, Filová, E, Bačáková, L
• Format: Journal Article
• Language: English
• Published: Czech Republic Institute of Physiology 2009
• Subjects: Animals; Biocompatible Materials; Biomedical materials; Bioprosthesis - history; Bioprosthesis - trends; Blood; Blood Vessel Prosthesis - history; Blood Vessel Prosthesis - trends; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - history; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - trends; Engineering research; Gene expression; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - prevention & control; Heart surgery; History, 20th Century; History, 21st Century; Humans; Prosthesis Design; Proteins; Shear stress; Time Factors; Tissue Engineering - history; Tissue Engineering - trends; Treatment Outcome; Vascular Diseases - physiopathology; Vascular Diseases - surgery; Vascular Patency; Veins & arteries
• ISSN: 0862-8408; 1802-9973
• DOI: 10.33549/physiolres.931918

The gold standard material in bypass surgery of blood vessels remains the patient's own artery or vein. However, this material may be unavailable, or may suffer vein graft disease. Currently available vascular prostheses, namely polyethylene terephthalate (PET, Dacron) and expanded polytetrafluoroethylene (ePTFE), perform well as large-caliber replacements, but their long-term patency is discouraging in small-caliber applications (<6 mm), such as in coronary, crural or microvessel surgery. This failure is mainly a result of an unfavorable healing process with surface thrombogenicity, due to lack of endothelial cells and anastomotic intimal hyperplasia caused by hemodynamic disturbances. An ideal small-diameter vascular graft has become a major focus of research. Novel biomaterials have been manufactured, and tissue-biomaterial interactions have been optimized. Tissue engineering technology has proven that the concept of partially or totally living blood vessels is feasible. The purpose of this review is to outline the vascular graft materials that are currently being implanted, taking into account cell-biomaterial physiology, tissue engineering approaches and the collective achievements of the authors.