Fabrication of small-diameter vascular grafts for cardiovascular diseases using electrospun polymer composites

Abstract

Cardiovascular disease is a leading cause of global mortality. Surgical treatments, including replacement or bypassing of the diseased vessels, are the most crucial treatment options for cardiac patients. Innovative methodologies of vascular tissue engineering have arisen as promising approaches to address the restrictions of using autografts, allografts, and xenografts. Already commercially available synthetic vascular grafts fail as vascular substitutes for small-diameter blood vessels due to various issues. Hence, a strong, flexible, biocompatible, thromboresistant, and durable small-caliber synthetic vascular scaffold for successful vascular implantation is in high demand. Electrospinning is the best technique for this fabrication because it can mimic the extracellular matrix structure of the native vascular tissue. Polymers comprise highly suitable components for fabricating synthetic vascular grafts, as they are inexpensive and safe compared to decellularized materials. Both synthetic and natural polymers have been used individually and in combinations. This combination can be performed via different advanced electrospinning techniques to obtain biological and mechanical properties similar to native vessels. In this review, the importance of vascular grafts and how they should mimic native vessels will be discussed. Also, we will explore why electrospinning is a suitable technique for graft fabrication and how it can be used to develop vascular grafts with appropriate properties for implantation. This paper uniquely combines a detailed consideration of polymer combinations and their measured mechanical and biological properties with a focused comparison of electrospinning techniques and their suitability for small-diameter vascular grafts. By linking historical developments, current challenges, and clear future directions, it provides clinicians and researchers with a concise, application-oriented roadmap for selecting and designing electrospun vascular scaffolds with improved clinical potential.