Cardiovascular disease (CVD) is a leading cause of death and hospitalization worldwide. The need for small caliber
vessels (<6mm) to treat CVD patients has grown; however the availability of autologous vessels in cardiac and peripheral bypass
candidates is limited. The search for an alternative vessel source is widespread with both natural and synthetic tissue engineered
materials being investigated as scaffolds. Despite decades of exhaustive studies with decellularized extracellular matrices
(ECM) and synthetic graft materials, the field remains in search of a commercially viable biomaterial construct substitute.
While the previous materials have been assessed by evaluating their compatibility with fibroblasts, smooth muscle cells
and endothelial cells, current materials are being conceived based on their interactions with stem cells, progenitor cells and
monocytes, as the latter may hold the key to repair and regeneration. The graft’s ability to recruit and maintain these cells has
become a major research focus. The successful tissue engineering of a small caliber vessel graft requires the use of optimal
material chemistry and biological function to promote cell recruitment into the graft while maintaining each functional phenotype
during vessel tissue maturation. The discussion of these significant research challenges constitutes the focus of this review.
Keywords: Extracellular matrix proteins, monocytes, natural biomaterials, progenitor cells, small caliber vessel, stem cells,
synthetic biomaterials, vascular tissue engineering
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