Currently, despite the success of percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) remains among the most commonly performed cardiac surgical procedures in the United States. Unfortunately, the use of autologous grafts in CABG presents a major clinical challenge as complications due to autologous vessel harvest and limited vessel availability pose a significant setback in the success rate of CABG surgeries. Acellular extracellular matrix (ECM) scaffolds derived from xenogeneic vascular tissues have the potential to overcome these challenges, as they offer unlimited availability and sufficient length to serve as "off-the-shelf" CABGs. Unfortunately, regardless of numerous efforts to produce a fully functional small diameter xenogeneic ECM scaffold, the combination of factors required to overcome all failure mechanisms in a single graft remains elusive. This article covers the major failure mechanisms of current xenogeneic small diameter vessel ECM scaffolds, and reviews the recent advances in the field to overcome these failure mechanisms and ultimately develop a small diameter ECM xenogeneic scaffold for CABG. Impact Statement Currently, the use of autologous vessel in coronary artery bypass graft (CABG) is common practice. However, the use of autologous tissue poses significant complications due to tissue harvest and limited availability. Developing an alternative vessel for use in CABG can potentially increase the success rate of CABG surgery by eliminating complications related to the use of autologous vessel. However, this development has been hindered by an array of failure mechanisms that currently have not been overcome. This article describes the currently identified failure mechanisms of small diameter vascular xenogeneic extracellular matrix scaffolds and reviews current research targeted to overcoming these failure mechanisms toward ensuring long-term graft patency.

中文翻译：

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用于血管应用的小直径异种细胞外基质支架。

当前，尽管经皮冠状动脉介入治疗（PCI）成功，但冠状动脉搭桥术（CABG）仍然是美国最常用的心脏外科手术之一。不幸的是，在CABG中使用自体移植物是一个重大的临床挑战，因为由于自体血管收获而引起的并发症和有限的血管可利用性严重阻碍了CABG手术的成功率。异种血管组织衍生的无细胞细胞外基质（ECM）支架具有克服这些挑战的潜力，因为它们提供了无限的可用性和足够的长度，可以用作“现成的” CABG。不幸的是，无论为制造功能齐全的小直径异种ECM支架付出了多大的努力，克服单个移植物中所有失败机制所需的因素组合仍然难以捉摸。本文介绍了当前异种小直径血管ECM支架的主要失效机理，并回顾了该领域克服这些失效机理的最新进展，并最终开发了CABG的小直径ECM异种支架。影响陈述当前，在冠状动脉旁路移植术（CABG）中使用自体血管是常见的做法。然而，由于组织的收获和有限的可用性，自体组织的使用带来了显着的并发症。通过消除与使用自体血管相关的并发症，开发用于CABG的替代血管可以潜在地提高CABG手术的成功率。然而，这一发展受到目前尚未克服的一系列故障机制的阻碍。本文介绍了目前确定的小直径血管异种细胞外基质支架的失效机制，并综述了旨在克服这些失效机制以确保长期移植通畅的当前研究。