Biomaterials and Modifications in the Development of Small-Diameter Vascular Grafts.

There remains a significant clinical need for an alternative to autologous vein grafts in small-diameter applications such as coronary bypass, but no clinically viable, synthetic small-diameter vascular grafts have been developed. While ePTFE and Dacron have long been used for large diameter grafts, it is likely that in small-diameter, low flow conditions, alternative materials and techniques are required, which have shown promising experimental results through enhancing compliance, biocompatibility, and endothelialization of vascular grafts. It is likely that the integration of synthetic materials that possess optimized mechanical properties combined with techniques for improved biocompatibility, such as the use of pure extracellular matrix proteins, will be the impetus for the creation of a new generation of clinically viable, small-diameter vascular substitutes.