ABSTRACT
I. Introduction .................................................................................................................... 371
II. Blood Vessel Structure and Function ............................................................................ 372
III. Endothelialization Strategies .......................................................................................... 374
IV. Scaffolding Strategies ...................................................................................................... 375
A. Degradable Synthetic Scaffolds ............................................................................. 375
B. Naturally-Derived Scaffolds ................................................................................... 377
C. Cell-Secreted Scaffolds .......................................................................................... 379
V. Biological Response to Scaffold .................................................................................... 380
VI. Summary and Future Directions .................................................................................... 381
Acknowledgments ....................................................................................................................... 381
References ................................................................................................................................... 381
The development of blood vessel substitutes using tissue engineering principles has rapidly
progressed in the past decade in response to the clinical need for improved vascular grafts in
surgical procedures, especially for small diameter applications. In the United States, around 40% of
all deaths are caused by cardiovascular disease, and more than half of these are a result of coronary
heart disease. Approximately 500,000 coronary artery bypass grafting procedures are performed
annually, each requiring a small diameter vascular conduit to bypass a blocked coronary artery.
There has been progress in understanding the biological mechanisms behind vascular disease, and
in developing pharmacological and interventional treatments, however, the in vitro and preclinical
test-beds for evaluating these therapies and for studying vascular biology are still underdeveloped.
For these reasons, there has been a strong interest in creating blood vessel analogs for use both
in vivo as surgical grafts, and in vitro as models of the vasculature.
