Building Scaffolds for New Blood Vessels

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Building Scaffolds for New Blood Vessels
Yow KH, Ingram J, Korossis SA, et al.
Br J Surg. 2005; 93: 652-661

Is it possible to grow vascular tissue suitable for revascularization or for vascular conduits? This report summarizes the various methods used for tissue engineering and the future prospects for what could be a valuable technique for limb salvage or for dialysis access. Endothelial or other suitable autologous cells can be used to line synthetic tubular scaffolds, yielding an immunologically compatible structure for vascular substitution. The technique could be invaluable for the considerable number of patients (10%-40%) who require grafts for procedures such as coronary artery or peripheral vascular bypass surgery, but who do not have suitable venous substitutes. Two approaches are available: (1) autologous cells are encouraged to grow on an inert scaffold in vitro; (2) the inert scaffold is implanted into the patient, with subsequent development in vivo of an endothelial lining.

Currently, the major obstacle to the use of tissue-engineered vascular conduits is the time required to fabricate a new conduit. For example, many patients with peripheral vascular disease and limb ischemia require prompt surgery; postponing surgery for several weeks to construct a suitable replacement conduit is not an option. The goal of future research is to develop a small-caliber inert scaffold that can be implanted with subsequent rapid formation of a smooth endothelial lining from circulating cells.

Abstract

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