Univ. Bordeaux, INSERM, BIOTIS, UMR1026, Bordeaux, F-33000, France.
Biofabrication. 2023 Mar 10;15(2). doi: 10.1088/1758-5090/acbf7a.
Cardiovascular diseases are the leading cause of mortality in the world and encompass several important pathologies, including atherosclerosis. In the cases of severe vessel occlusion, surgical intervention using bypass grafts may be required. Synthetic vascular grafts provide poor patency for small-diameter applications (< 6 mm) but are widely used for hemodialysis access and, with success, larger vessel repairs. In very small vessels, such as coronary arteries, synthetics outcomes are unacceptable, leading to the exclusive use of autologous (native) vessels despite their limited availability and, sometimes, quality. Consequently, there is a clear clinical need for a small-diameter vascular graft that can provide outcomes similar to native vessels. Many tissue-engineering approaches have been developed to offer native-like tissues with the appropriate mechanical and biological properties in order to overcome the limitations of synthetic and autologous grafts. This review overviews current scaffold-based and scaffold-free approaches developed to biofabricate tissue-engineered vascular grafts (TEVGs) with an introduction to the biological textile approaches. Indeed, these assembly methods show a reduced production time compared to processes that require long bioreactor-based maturation steps. Another advantage of the textile-inspired approaches is that they can provide better directional and regional control of the TEVG mechanical properties.
心血管疾病是世界上导致死亡的主要原因,包括几种重要的病理学,如动脉粥样硬化。在严重的血管闭塞情况下,可能需要使用旁路移植物进行手术干预。合成血管移植物在小直径应用(<6mm)中提供较差的通畅性,但广泛用于血液透析通路,并成功地用于较大血管修复。在非常小的血管,如冠状动脉,合成物的结果是不可接受的,导致尽管自体(天然)血管的可用性有限,并且有时质量有限,也只能使用自体血管。因此,临床明确需要一种能够提供类似于天然血管的结果的小直径血管移植物。已经开发了许多组织工程方法,以提供具有适当机械和生物学特性的类似天然的组织,以克服合成和自体移植物的局限性。这篇综述概述了目前基于支架和无支架的方法,用于生物制造组织工程血管移植物(TEVG),并介绍了生物纺织方法。事实上,与需要长时间基于生物反应器的成熟步骤的过程相比,这些组装方法显示出缩短的生产时间。受纺织启发的方法的另一个优点是,它们可以更好地控制 TEVG 的机械性能的方向性和区域性。