Development of tissue engineered vascular grafts.

Vascular bypass grafting is a commonly performed procedure for ischemic heart disease and peripheral vascular disease. However, approximately one in fourteen patients do not have suitable autologous arteries or veins available for grafting. Synthetic vascular grafts were introduced in the 1960s to overcome these problems, but while they perform adequately in high-flow, large-diameter vessel settings they are generally not suited to low-flow, small-diameter vessels. Tissue engineering is a relatively new discipline that offers the potential to create replacement structures from autologous cells and biodegradable polymer scaffolds. Because tissue engineering constructs contain living cells, they may have the potential to grow, self-repair, and self-remodel. Therefore, recently there has been much interest in the use of this technique to produce low-flow small-diameter arteries. The latest and most exciting developments in this area involve the use of multipotent stem cells as a cell source for tissue engineering of vascular grafts (both in vivo and in vitro).