Vascular grafts have long been used to replace damaged or diseased vessels with considerable success, but a new approach is emerging where native vessels are merely supported, not replaced. Although external supports have been evaluated in diverse situations – ranging from aneurysmal disease to vein grafts or the Ross operation – optimal supports and procedures remain wanting. In this paper, we present a novel application of a growth and remodeling model well suited for parametrically exploring multiple designs of external supports while accounting for mechanobiological and immunobiological responses of the supported native vessel. These results suggest that a load bearing external support can reduce vessel thickening in response to pressure elevation. Results also suggest that the final adaptive state of the vessel depends on the structural stiffness of the support via a mechano-driven adaptation, although luminal encroachment may be a complication in the presence of chronic inflammation. Finally, the supported vessel can stiffen (structurally and materially) along circumferential and axial directions, which could have implications on overall hemodynamics and thus subsequent vascular remodeling. The proposed framework can provide valuable insights into vascular adaptation in the presence of external support, accelerate rational design, and aid translation of this emerging approach.

长期以来，血管移植已被广泛用于替换受损或患病的血管，但是一种新的方法正在兴起，其中仅支持而不是替换天然血管。尽管在各种情况下（从动脉瘤疾病到静脉移植或Ross手术）评估了外部支持，但仍需要最佳支持和程序。在本文中，我们提出了一种增长和重塑模型的新应用，该模型非常适合在参数化探索外部支持物的多种设计的同时，还考虑了所支持的天然血管的机械生物学和免疫生物学反应。这些结果表明，承重的外部支撑件可以响应于压力升高而减小血管的增厚。结果还表明，血管的最终适应状态取决于通过机械驱动适应的支持物的结构刚度，尽管在慢性炎症的存在下管腔侵犯可能是一种并发症。最后，被支撑的血管可以沿周向和轴向（结构上和物质上）变硬，这可能对整体血液动力学和随后的血管重塑有影响。所提出的框架可以在存在外部支持的情况下提供有关血管适应的有价值的见解，加快合理的设计，并有助于这种新兴方法的翻译。被支撑的血管会沿周向和轴向（结构上和物质上）变硬，这可能对总体血液动力学和随后的血管重塑有影响。所提出的框架可以在存在外部支持的情况下提供有关血管适应的有价值的见解，加快合理的设计，并有助于这种新兴方法的翻译。被支撑的血管会沿周向和轴向（结构上和物质上）变硬，这可能对总体血液动力学和随后的血管重塑有影响。所提出的框架可以在存在外部支持的情况下提供有关血管适应的有价值的见解，加快合理的设计，并有助于这种新兴方法的翻译。