Ex Vivo Formation of Blood Vessels
Vascular bypass grafts represent a well-grounded technological advance in the new millennium, this being related to the high prevalence of atherosclerosis and the ensuing treatment of myocardial infarction [1]. However, more recently a paradigm shift has
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ntents 47.1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . 685
47.2
Ideal Vascular Graft . . . . . . . . . . . . . . . . . . 686
47.3
Tissue-Engineered Vascular Grafts . . . . . . 686
47.3.1 Scaffold . . . . . . . . . . . . . . . . . . . . . . . . . . . 687 47.3.2 Matrix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 688 47.3.3 Endothelialisation . . . . . . . . . . . . . . . . . . . . 689 47.4
Current Problems . . . . . . . . . . . . . . . . . . . . 689
47.5
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . 690 References . . . . . . . . . . . . . . . . . . . . . . . . . 691
47.1
Introduction
Vascular bypass grafts represent a well-grounded technological advance in the new millennium, this being related to the high prevalence of atherosclerosis and the ensuing treatment of myocardial infarction [1]. However, more recently a paradigm shift has occurred casting the subject of vascular tissue engineering in new light. The development of cardiovascular devices both for high- and low-flow scenarios in the form of functional vascular prostheses has
47
made this possible. While the patency rates of highflow vessels [2], such as polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) grafts following prolonged clinical use are acceptable, these figures are less satisfactory at lower flow rates [3]. Given the limitations with synthetic materials alone, a biological or biohybrid vascular prosthesis could provide us with the ideal blood vessel substitute. The current interest in developing artificial organs such as the tissue-engineered bladders [4] and composite tissue has sparked renewed interest in this field. In the latter case, the limitations of immunogenicity with allotransplantation [5] have put the development of these blood vessels, and in particular the development of artificial capillary systems [6], at the forefront. Such integrated vascular networks would serve to nourish the various tissue planes within a tissue-engineered construct [7]. This has formed the basis for the emphasis of developing small-calibre (
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