Strategies and Techniques to Enhance the In Situ Endothelialization of Small-Diameter Biodegradable Polymeric Vascular Grafts

• Published in: Tissue engineering. Part B, Reviews Vol. 19; no. 4; pp. 292 - 307
• Main Authors: Melchiorri, Anthony J., Hibino, Narutoshi, Fisher, John P.
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc 01.08.2013
• Subjects: Absorbable Implants; Animals; Biodegradation; Blood Vessel Prosthesis; Endothelium; Endothelium, Vascular - cytology; Endothelium, Vascular - metabolism; Humans; Polymerization; Review; Review Articles; Skin & tissue grafts; Tissue Engineering - methods; Vascular endothelial growth factor
• ISSN: 1937-3368; 1937-3376
• DOI: 10.1089/ten.teb.2012.0577

Due to the lack of success in small-diameter (<6 mm) prosthetic vascular grafts, a variety of strategies have evolved utilizing a tissue-engineering approach. Much of this work has focused on enhancing the endothelialization of these grafts. A healthy, confluent endothelial layer provides dynamic control over homeo-stasis, influencing and preventing thrombosis and smooth muscle cell proliferation that can lead to intimal hyperplasia. Strategies to improve endothelialization of biodegradable polymeric grafts have encompassed both chemical and physical modifications to graft surfaces, many focusing on the recruitment of endothelial and endothelial progenitor cells. This review aims to provide a compilation of current and developing strategies that utilize in situ endothelialization to improve vascular graft outcomes, providing a context for the future directions of vascular tissue-engineering strategies that do not require preprocedural cell seeding.