Cytograft Tissue Engineering Inc., Novato, Calif., USA.
Cells Tissues Organs. 2012;195(1-2):144-58. doi: 10.1159/000331406. Epub 2011 Oct 13.
Dacron® (polyethylene terephthalate) and Goretex® (expanded polytetrafluoroethylene) vascular grafts have been very successful in replacing obstructed blood vessels of large and medium diameters. However, as diameters decrease below 6 mm, these grafts are clearly outperformed by transposed autologous veins and, particularly, arteries. With approximately 8 million individuals with peripheral arterial disease, over 500,000 patients diagnosed with end-stage renal disease, and over 250,000 patients per year undergoing coronary bypass in the USA alone, there is a critical clinical need for a functional small-diameter conduit [Lloyd-Jones et al., Circulation 2010;121:e46-e215]. Over the last decade, we have witnessed a dramatic paradigm shift in cardiovascular tissue engineering that has driven the field away from biomaterial-focused approaches and towards more biology-driven strategies. In this article, we review the preclinical and clinical efforts in the quest for a tissue-engineered blood vessel that is free of permanent synthetic scaffolds but has the mechanical strength to become a successful arterial graft. Special emphasis is given to the tissue engineering by self-assembly (TESA) approach, which has been the only one to reach clinical trials for applications under arterial pressure.
涤纶（聚对苯二甲酸乙二醇酯）和戈尔（膨体聚四氟乙烯）血管移植物在替换大、中直径的阻塞血管方面非常成功。然而，当直径小于 6 毫米时，这些移植物在性能上明显逊于自体转位静脉，尤其是动脉。仅在美国，就有大约 800 万人患有外周动脉疾病，50 多万人被诊断为终末期肾病，每年有超过 25 万人接受冠状动脉旁路手术，因此对一种功能性小直径导管存在着重大的临床需求[Lloyd-Jones 等人，循环 2010；121：e46-e215]。在过去的十年中，我们见证了心血管组织工程学的巨大范式转变，这一转变推动该领域从以生物材料为重点的方法向更具生物学导向的策略发展。在本文中，我们回顾了在寻找一种无永久性合成支架的组织工程血管的努力，这种血管具有足够的机械强度，可以成为一种成功的动脉移植物。特别强调了自组装组织工程（TESA）方法，这是唯一一种在动脉压力下应用进入临床试验的方法。
