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History, progress and future challenges of artificial blood vessels: a narrative review
Ke Hu1, Yuxuan Li1, Zunxiang Ke2
1Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Insights
Artificial blood vessels are crucial for treating cardiovascular disease, especially for small-diameter replacements where synthetic options fail. Tissue-engineered vascular grafts show promise but require further research for clinical use.
Area of Science:
- Biomaterials Science
- Regenerative Medicine
- Cardiovascular Surgery
Background:
- Cardiovascular disease is the leading cause of death globally, often necessitating vascular replacement due to stenosis or occlusion.
- Limited availability of autologous vessels and complications drive the need for artificial blood vessels.
- Current synthetic grafts are unsuitable for small-diameter applications, highlighting a critical gap in treatment options.
Purpose of the Study:
- To review the challenges and advancements in the generation of artificial blood vessels.
- To discuss state-of-the-art technologies for creating artificial vascular grafts.
- To explore preclinical and clinical applications, alongside evaluation methods and future research directions.
Main Methods:
- Review of current literature on artificial blood vessel materials and fabrication.
- Analysis of surface modification techniques for enhanced biocompatibility.
- Discussion of in vitro and in vivo evaluation methodologies for vascular grafts.
Main Results:
- Synthetic grafts are effective for medium-to-large diameters but fail in small vessels.
- Tissue-engineered vascular grafts (TEVGs) are a promising alternative for small-diameter vascular replacement.
- Significant challenges remain in material science, fabrication, and preclinical/clinical validation of TEVGs.
Conclusions:
- TEVGs represent a potential ideal alternative to autologous grafts for small-diameter vascular repair.
- Further research and technological development are essential to overcome existing hurdles for biomedical applications.
- Comprehensive evaluation of mechanical properties and biological performance is critical for successful clinical translation.
Abstract:
Cardiovascular disease serves as the leading cause of death worldwide, with stenosis, occlusion, or severe dysfunction of blood vessels being its pathophysiological mechanism. Vascular replacement is the preferred surgical option for treating obstructed vascular structures. Due to the limited availability of healthy autologous vessels as well as the incidence of postoperative complications, there is an increasing demand for artificial blood vessels. From synthetic to natural, or a mixture of these components, numerous materials have been used to prepare artificial vascular grafts. Although synthetic grafts are more appropriate for use in medium to large-diameter vessels, they fail when replacing small-diameter vessels. Tissue-engineered vascular grafts are very likely to be an ideal alternative to autologous grafts in small-diameter vessels and are worthy of further investigation. However, a multitude of problems remain that must be resolved before they can be used in biomedical applications. Accordingly, this review attempts to describe these problems and provide a discussion of the generation of artificial blood vessels. In addition, we deliberate on current state-of-the-art technologies for creating artificial blood vessels, including advances in materials, fabrication techniques, various methods of surface modification, as well as preclinical and clinical applications. Furthermore, the evaluation of grafts both in vivo and in vitro, mechanical properties, challenges, and directions for further research are also discussed.
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