The University of Southampton

Could tissue-engineered blood vessels transform the treatment of vascular disease?

Following our lecture on sensors I was intrigued to find out more about the uses of Doppler Ultrasound in medicine. The body’s vasculature is complex and intricate, and serves a crucial role in keeping our organs and body alive. Ironically, this fundamental element for survival has potential to present a significant threat to life.

The Doppler effect is used to measure the velocity of red blood cells

What is Doppler Ultrasound?

Doppler Ultrasound is a non-invasive method of measuring blood flow through a vessel using sound waves and is important in diagnosing conditions such as heart valve defects, aneurysms, and blocked or narrowing arteries. Additionally, Doppler Ultrasound is essential in monitoring blood flow in vessels before and after specific surgeries, including organ transplants, heart-valve replacements, and stent implantations.

I was fortunate enough to talk to a Clinical Vascular Scientist about the importance of Doppler Ultrasound in her day-to-day work:

A significant health concern?

After speaking with Marie, I became increasingly aware of how prevalent vascular disease is in the UK, with heart and circulatory diseases causing 26% of all deaths in England. That’s one death every four minutes! Vascular disease is severe and can result in poor wound healing, organ damage, stroke, heart attack, and even amputation of limbs. I had a discussion with Bethany, a student nurse who recently completed a placement on a Cardiac Intensive Care Unit. Bethany gave me valuable insight into the negative impacts that vascular disease has on both a patient’s quality of life and the NHS. I was shocked to find out that CVD-related healthcare costs amount to about ÂŁ7.4 billion per year in England! This prompted me to question, “Could tissue-engineering replacement blood vessels serve as a viable option in the treatment of some vascular diseases?”.

The three main layers that make up blood vessels

Are they needed?

I looked into some current surgical treatment options and found that stents are commonly used to restore blood flow in a narrowed or blocked artery. However, when multiple arteries become blocked, an artery bypass graft may be performed using segments of healthy blood vessels from other parts of the body. “Would tissue-engineering new blood vessels be necessary if bypass grafts are usually successful?” I thought, especially when they would face a minimal risk of rejection coming from the patient themselves. After reflecting on this question, I concluded that tissue-engineered blood vessels would add value if successful. Some patients don’t have suitable blood vessels in other parts of the body to use in a bypass graft, and this shortage is a factor that could be overcome. Additionally, the vessel could be perfectly engineered to fit the patient and “grow” as they age.

How far away are we from successful tissue engineering of blood vessels?

Weinberg and Bell tissue-engineered the first blood vessel in 1986 using collagen, smooth muscle cells, endothelial cells, and fibroblasts. Adult stem cells are usually preferred as a cell source in tissue-engineered blood vessels over embryonic stem cells due to lower ethical concerns. I created a timeline with some key dates leading up to the development of the first tissue-engineered blood vessel to help organise my thoughts.

Timeline of key dates

I was pleasantly surprised by the developments made through the years as blood vessels are such complex structures and this creates many challenges. Although progress has been made since 1986, there is still a long way to go before these blood vessels reach the clinic, but I believe we are not too far off witnessing significant advancements in vascular medicine.

How technology has allowed a man to walk again?

I have come across an article

A heart condition meant Ryan required a transplant at 18, however after suffering a cardiac arrest just a few days later, lack of blood flow to his legs caused his calf muscles to die and he needed amputation of both legs. Ryan was fitted with prosthetic limbs but walking with these new legs became too painful and he had to stop. He was then fitted with a spinal cord simulator which sends small electrical impulses to his spinal cord and blocks pain signals travelling back to his brain. Since this device was fitted Ryan says his life has changed. He is able to walk again and even enjoys nights out with his brother and friends 🙂