Biomedical Engineering Reference
In-Depth Information
CHAPTER
7
BLOOD VESSEL
REGENERATION
Jesse K. Placone and John P. Fisher
Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
7.1
INTRODUCTION
In the field of tissue engineering, one of the most rapidly advancing areas of study is blood vessel
regeneration. This area focuses on the development of technologies and methods to encourage new
vessel growth, angiogenesis, or the repair and replacement of native blood vessels. New vessel for-
mation has specific applications to the survival of implanted organs as discussed in another chapter
in this topic. The replacement of native blood vessels has direct therapeutic applications due to the
prevalence of cardiovascular diseases worldwide (
Go et al., 2012
;
Roger et al., 2012
). Cardiovascular
disease and congenital heart disease have had significant advances in their treatment and care; however,
the usage of synthetic materials still leaves much to be desired due to complications associated with
their use. These artificial grafts typically have problems with the progressive occlusion of the implant
because of a lack of growth potential and an increase in thromboebolic events (
Stark, 1998
;
Cleve-
land et al., 1992
); (
Jonas et al., 1985
;
Lamers et al., 2012
). As such, the field of tissue engineering has
been investigating multiple routes toward the development of a vascular graft that has the potential to
overcome some of the shortcomings of traditional vascular grafts and improve the quality of life for
the patient.
In this chapter, we will discuss some of the recent technologies that have been developed to address
problems in this field, and each approach's potential future directions to become clinically relevant for
cardiovascular disease treatments and for the implantation of other tissue-engineered implants. The
current approaches can be divided into cell-based and cell-free systems where man-made scaffolds or
grafts are generated to provide the foundation for blood vessel regeneration. Both approaches make
use of micro- to nanoscale architecture, embedded or attached growth factors or therapeutics, and
tunable mechanical properties to better mimic the native tissue and its heterogeneous composition of
cells and extracellular matrices.
The most basic description of blood vessels typically illustrates the blood vessel as consisting of
three main layers. These layers, the tunica intima, the tunica media, and the tunica adventitia, are or-
ganized as concentric layers from the inside out and all have distinct cellular and matrix components.
The innermost layer, the tunica intima, consists of an endothelial cell layer that completely covers the
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