Department of Mechanical Engineering, University of Wisconsin, Madison, WI, USA.
School of Mechanics and Engineering Science, Zhengzhou University, Zhengzhou 450001, P. R. China and National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou 450001, P. R. China.
J Mater Chem B. 2020 Mar 4;8(9):1801-1822. doi: 10.1039/c9tb01849b.
Cardiovascular diseases, especially ones involving narrowed or blocked blood vessels with diameters smaller than 6 millimeters, are the leading cause of death globally. Vascular grafts have been used in bypass surgery to replace damaged native blood vessels for treating severe cardio- and peripheral vascular diseases. However, autologous replacement grafts are not often available due to prior harvesting or the patient's health. Furthermore, autologous harvesting causes secondary injury to the patient at the harvest site. Therefore, artificial blood vessels have been widely investigated in the last several decades. In this review, the progress and potential outlook of small-diameter blood vessels (SDBVs) engineered in vitro are highlighted and summarized, including material selection and development, fabrication techniques, surface modification, mechanical properties, and bioactive functionalities. Several kinds of natural and synthetic polymers for artificial SDBVs are presented here. Commonly used fabrication techniques, such as extrusion and expansion, electrospinning, thermally induced phase separation (TIPS), braiding, 3D printing, hydrogel tubing, gas foaming, and a combination of these methods, are analyzed and compared. Different surface modification methods, such as physical immobilization, surface adsorption, plasma treatment, and chemical immobilization, are investigated and are compared here as well. Mechanical requirements of SDBVs are also reviewed for long-term service. In vitro biological functions of artificial blood vessels, including oxygen consumption, nitric oxide (NO) production, shear stress response, leukocyte adhesion, and anticoagulation, are also discussed. Finally, we draw conclusions regarding current challenges and attempts to identify future directions for the optimal combination of materials, fabrication methods, surface modifications, and biofunctionalities. We hope that this review can assist with the design, fabrication, and application of SDBVs engineered in vitro and promote future advancements in this emerging research field.
心血管疾病，尤其是那些涉及直径小于 6 毫米的狭窄或阻塞血管的疾病，是全球范围内的主要死亡原因。血管移植物已被用于旁路手术中，以替代受损的天然血管，用于治疗严重的心血管和外周血管疾病。然而，由于先前的采集或患者的健康状况，自体替代移植物并不经常可用。此外，自体采集会在采集部位对患者造成二次损伤。因此，在过去几十年中，人工血管已被广泛研究。在这篇综述中，突出并总结了体外工程小直径血管（SDBV）的进展和潜在前景，包括材料选择和开发、制造技术、表面改性、机械性能和生物活性功能。本文介绍了几种用于人工 SDBV 的天然和合成聚合物。这里分析和比较了几种常用的制造技术，如挤出和膨胀、静电纺丝、热致相分离（TIPS）、编织、3D 打印、水凝胶管、气体发泡以及这些方法的组合。还研究和比较了不同的表面改性方法，如物理固定、表面吸附、等离子体处理和化学固定。还回顾了 SDBV 的机械要求，以确保其长期使用。此外，还讨论了人工血管的体外生物学功能，包括耗氧量、一氧化氮（NO）产生、切应力响应、白细胞黏附性和抗凝性。最后，我们总结了当前的挑战和尝试，以确定材料、制造方法、表面改性和生物功能的最佳组合的未来方向。我们希望这篇综述能有助于设计、制造和应用体外工程的 SDBV，并促进这一新兴研究领域的未来发展。
