Artificial blood vessel: The Holy Grail of peripheral vascular surgery

Abstract

Artificial blood vessels composed of viable tissue represent the ideal vascular graft. Compliance, lack of thrombogenicity, and resistance to infections as well as the ability to heal, remodel, contract, and secrete normal blood vessel products are theoretical advantages of such grafts. Three basic elements are generally required for the construction of an artificial vessel: a structural scaffold, made either of collagen or a biodegradable polymer; vascular cells, and a nurturing environment. Mechanical properties of the artificial vessels are enhanced by bioreactors that mimic the in vivo environment of the vascular cells by producing pulsatile flow. Alternative approaches include the production of fibrocollagenous tubes within the recipient's own body (subcutaneous tissue or peritoneal cavity) and the construction of an artificial vessel from acellular native tissues, such as decellularized small intestine submucosa, ureter, and allogeneic or xenogeneic arteries. This review details the most recent developments on vascular tissue engineering, summarizes the results of initial experiments on animals and humans, and outlines the current status and the challenges for the future.

The Future Prospects of Microbial Cellulose in Biomedical Applications

“…The mold is removed prior to implantation of the graft. 68 SEM observations of the implanted BASYC product showed that both the suture line and the suture material were not visible under the cell layer. In comparison, 4 weeks after the completion of end-to-end anastomosis (the union of nerve fibers), the same areas of the control rat (without BASYC) were not completely covered with endothelial cells and the suture material was still visible.…”

“…66,67 According to Kakisis et al, there are three basic requirements for the construction of an artificial vessel: (a) a sufficient structural scaffold which provides the desired shape and support for cell growth, (b) the proliferation of vascular cells, and (c) a proper nurturing environment. 68 The development of synthetic, small-diameter grafts with mechanical properties similar to those of native arteries, and which are easy to store and handle, is significantly important for certain medical applications. 68 According to Yamanaka et al, the hollow microbial cellulose tubes proved to be biocompatible, especially with blood, and exhibited high durability.…”

“…68 The development of synthetic, small-diameter grafts with mechanical properties similar to those of native arteries, and which are easy to store and handle, is significantly important for certain medical applications. 68 According to Yamanaka et al, the hollow microbial cellulose tubes proved to be biocompatible, especially with blood, and exhibited high durability. 65 Studies on animal models were used to evaluate blood compatibility by substituting the parts of the descending aorta and jugular vein of an adult dog with an artificial blood vessel composed of microbial cellulose.…”

“…65 According to Kakisis, an artificial blood vessel composed of viable tissue can be considered as an ideal vascular graft. 68 Alternative approaches include the production of fibrocollagenous tubes within the recipient's body or by designing such vessels from acellular native tissues. 68 Most of the existing scaffolds for vessels are based on collagen matrices or other biodegradable polymers which have the proper mechanical properties.…”

“…68 So far, several biodegradable polymers have been used as potential scaffolds for the design of artificial vessels. Among them, polyglycolic acid (PGA), which is highly porous, easy to handle, and can be made into different shapes, is commonly used.…”