Preclinical studies of acellular extracellular matrices as small-caliber vascular grafts

Due to morbidity and mortality of cardiovascular diseases around the globe, there has been an unmet clinical need for small caliber vascular grafts. Autologous vessels are still the gold standard for small caliber vascular grafts (<6 mm). In an attempt to develop a tissue-engineered vascular graft, several approaches have been pursued. One of the promising techniques is the use of acellular matrices offering a prospect of being able to meet the demand for small caliber vessels. Acellular matrices can ideally preserve the vascular wall complexity, biochemical properties, and bioactivity required for tissue regeneration and function. Various strategies have emerged to increase long term patency of acellular matrices including surface modification and pre-implantation cell seeding. This article reviews the most recent and relevant in vivo studies on acellular small caliber vascular grafts, which provides an outlook toward the preclinical potential of acellular extracellular matrices in vascular tissue engineering.