Rolled amniotic membrane for practical vascular graft development: a scoping review

Small-diameter vascular grafts remain a clinical challenge due to thrombosis, stenosis, and poor long-term patency of synthetic substitutes. Decellularised human amniotic membrane (dHAM), derived from placental tissue, offers a promising alternative because of its natural extracellular matrix, low immunogenicity, and broad availability. A scoping review was conducted to assess the practicality of rolling dHAM as a tubular vascular graft. Systematic searches of PubMed, Scopus, Web of Science, and EBSCOhost identified 238 records. After duplicate removal and screening, eight studies met the inclusion criteria and were analysed. dHAM was fabricated into multilayered tubular constructs with customisable dimensions. Decellularisation protocols efficiently removed cellular components while preserving ECM integrity, resulting in strong in vitro biocompatibility and mechanical performance. The addition of silica nanoparticles improved graft robustness by enhancing interfacial self-adherence. Preclinical studies in rats and rabbits demonstrated successful implantation with long-term patency up to 16 months, with minimal thrombosis, stenosis, or aneurysm formation. In a porcine carotid model, dHAM outperformed expanded polytetrafluoroethylene by reducing neointimal hyperplasia and promoting endothelialisation. dHAM offers tunable mechanical performance, regenerative potential, and accessibility, positioning it as a strong candidate for small-diameter vascular grafts. To advance towards clinical application, the existing body of evidence remains limited, underscoring the need for further research to evaluate rolling-based strategies and their reproducibility, optimisation potential, and clinical translatability.