HYBRID BIOMATERIALS FOR ENGINEERING VASCULAR TISSUES - Biologically-Responsive Hybrid Biomaterials - page 361

CHAPTER 14

HYBRID BIOMATERIALS FOR ENGINEERING VASCULAR
TISSUES

Thomas C. Flanagan 1 , Sebastian Olszewski 2 , Julia Frese 2 and Stefan Jockenhoevel 2 *
1

School of Medicine & Medical Science, Health Sciences Centre, University College
Dublin, Belfield, Dublin 4, Ireland

2

Department of Applied Medical Engineering, Helmholtz Institute for Biomedical
Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074 Aachen, Germany
* E-mail: [e-mail]

1. Introduction

Vascular disease is the most frequent cause of death in Western society [1]. The
most common presentation is atherosclerosis, a slow, complex inflammatory
disease process resulting in a thickening of the inner arterial lining. Occluded
vessels resulting from coronary and peripheral atherosclerosis can lead to
ischemic tissue in the heart and lower limb, respectively, which may result in
myocardial infarction or lower limb loss. In such patients, the capacity for
intrinsic tissue repair is severely compromised, and surgical intervention is
generally required to restore blood flow to the tissues. Potential treatments of
occluded coronary or peripheral vessels include anti-thrombotic therapy,
angioplasty/stent deployment, arterial by-pass grafting and therapeutic

angiogenesis.
In the cases of both coronary and peripheral artery occlusion, normal blood
flow can be restored to the tissue using balloon angioplasty, in which a catheter
is advanced to the site of obstruction using minimally-invasive percutaneous
techniques, and the balloon is subsequently inflated to compress the
atherosclerotic plaque against the arterial wall. In these cases, however, the
arteries frequently undergo restenosis (re-narrowing) [2] - a reparative process
that occurs after injury to the endothelium. The incidence of restenosis can be
significantly reduced by implanting an expandable stainless steel or nitinol stent
at the occlusion site during the angioplasty procedure. Despite advances in the

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