Biomedical Engineering Reference
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Fig. 4 Evolution of (left) MMP2 (middle) Collagen and (right) VSMCs, when a stent strut was
deployed to obtain an expansion ratio of 1.2. (Image courtesy of [
58
] with permission)
recruited from the circulation system into the site of injury, as well as various
individual growth factors secreted by the cells. The multiscale nature of the model
can also be further extended to the intracellular level by explicit modelling of events
that are initiated by cell level stimuli. As such, mechanotransduction through
various signalling pathways, including Ca
2+
and Rho signalling in VSMCs and
subsequent gene expression, could potentially be included in the model.
2.3 Intimal Hyperplasia in Tissue Engineered Vascular Grafts
The need for an alternative to native blood vessels for use as bypass grafts in
coronary artery bypass graft surgery has led to considerable research into tissue
engineering a blood vessel substitute [
45
]. For the successful development of a
tissue engineered blood vessel (TEBV), vascular cells and specifically VSMCs
seeded on the blood vessel scaffold should ideally proliferate and populate the
scaffold, synthesise an extracellular matrix similar to that of a native artery, and
subsequently adopt a contractile and quiescent phenotype. Failure of VSMCs to
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