Innovative Tissue-Engineered and Synthetic Vascular Graft Models for the Treatment of PAD in Small-Diameter Arteries

Abstract: Current treatment of peripheral arterial disease (PAD) incorporates a variety of methods that aim to restore normal vascular flow in the peripheral arteries. Treatment options to prevent complications such as chronic critical limb ischemia often include autografts, percutaneous transluminal angioplasty, stents, or synthetic grafts. In small-diameter arteries, such as those located in the lower leg, most of these treatment options often seek to control symptoms instead or trying to restore complete vascularization through the artery. There are design niches to come up with better alternatives to treat long-term complications derived from PAD in the lower limbs. To meet this goal, more research is still needed to dedicate to the treatment of PAD in small-diameter arteries. This review will provide design rationale and results on (a) major clinical breakthroughs in the development of small-diameter tissue-engineered blood vessels (TEBVs) and (b) innovative research involving TEBVs and synthetic vascular grafts. This review will also describe the main characteristics of the TEBV and synthetic vascular graft designs presented in these research groups to provide a basis for future research related to the treatment of PAD in small-diameter arteries. Lay Summary: Excess fatty deposits within arteries can lead to occlusion in the small arteries below the knee. When this happens, there can be complications involving the loss of movement of the leg and foot. Methods primarily designed to treat larger arteries are commonly used to treat these complications. However, several issues may arise with these methods that often lead to additional treatment costs to patients. New techniques aimed specifically at replacing occluded arteries have been developed in the last few years. The reasoning behind these techniques and the studies that examined them are described in this review. © 2017, The Regenerative Engineering Society.