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A bioactive compliant vascular graft modulates macrophage polarization and maintains patency with robust vascular remodeling.

  • Stahl, Alexander1, 2
  • Hao, Dake3, 4
  • Barrera, Janos5
  • Henn, Dominic5
  • Lin, Sien1
  • Moeinzadeh, Seyedsina1
  • Kim, Sungwoo1
  • Maloney, William1
  • Gurtner, Geoffrey5
  • Wang, Aijun3, 4, 6
  • Yang, Yunzhi Peter1, 7, 8
  • 1 Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA, 94304, USA.
  • 2 Department of Chemistry, Stanford University, 121 Mudd Building, Stanford, CA, 94305, USA.
  • 3 Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA, 95817, USA.
  • 4 Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, 95817, USA.
  • 5 Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
  • 6 Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA.
  • 7 Department of Materials Science and Engineering, Stanford University, 496 Lomita Mall, Stanford, CA, 94305, USA.
  • 8 Department of Bioengineering, Stanford University, 443 Via Ortega, Stanford, CA, 4305, USA.
Published Article
Bioactive Materials
KeAi Publishing
Publication Date
Jan 01, 2023
DOI: 10.1016/j.bioactmat.2022.04.004
PMID: 35510174


Conventional synthetic vascular grafts are associated with significant failure rates due to their mismatched mechanical properties with the native vessel and poor regenerative potential. Though different tissue engineering approaches have been used to improve the biocompatibility of synthetic vascular grafts, it is still crucial to develop a new generation of synthetic grafts that can match the dynamics of native vessel and direct the host response to achieve robust vascular regeneration. The size of pores within implanted biomaterials has shown significant effects on macrophage polarization, which has been further confirmed as necessary for efficient vascular formation and remodeling. Here, we developed biodegradable, autoclavable synthetic vascular grafts from a new polyurethane elastomer and tailored the grafts' interconnected pore sizes to promote macrophage populations with a pro-regenerative phenotype and improve vascular regeneration and patency rate. The synthetic vascular grafts showed similar mechanical properties to native blood vessels, encouraged macrophage populations with varying M2 to M1 phenotypic expression, and maintained patency and vascular regeneration in a one-month rat carotid interposition model and in a four-month rat aortic interposition model. This innovative bioactive synthetic vascular graft holds promise to treat clinical vascular diseases. © 2022 The Authors.

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