Understanding and manipulating the biological response to vascular implants.
Wound healing is a very complex and dynamic process that involves both stimulation and inhibition of cells and bioactive substances, resulting in a stable scar. Although the histological aspects of this response are well understood, the regulation of wound healing on a molecular level has not been completely elucidated. An "appropriate" healing response is crucial after vascular graft implantation to permit a functioning patent conduit. If the biological response is unfavorable, graft failure ensues. Clearly, it has been shown that the patency for prosthetic vascular implants is less favorable than for autologous implants in certain anatomic positions. However, the factors that promote this failure have not been fully identified. This article reviews the normal biological response to vascular graft healing as we understand it and provides some alternatives to manipulate the cellular milieu in an attempt to promote a more favorable healing response to prosthetic implantation.
Mikucki
S A
SA
Department of Surgery, Loyola University Medical Center, Maywood, IL 60153, USA.
Greisler
H P
HP
D000327:Adsorption; D000818:Animals; D001798:Blood Proteins / Q000378:metabolism; D019917:Blood Vessel Prosthesis Implantation; D002448:Cell Adhesion; D006085:Graft Survival; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D013499:Surface Properties; D014945:Wound Healing
D001798:Blood Proteins; D006133:Growth Substances