AccScience Publishing / STI / Volume 46 / Issue 1 / DOI: 10.36922/sti.0225
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REVIEW

Biological Materials in Vascular Surgery: Clinical Applications, Benefits, and Limitations

Tijmen W. Kraai1* ,  Johannes W. Drouven1 ,  David J. Liesker2 ,  Ben R. Saleem1 ,  Clark J. Zeebregts1
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1 Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
2 Department of Surgery, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
STI 2026, 46(1), 1–10; https://doi.org/10.36922/sti.0225
Received: 29 July 2025 | Revised: 30 October 2025 | Accepted: 11 November 2025 | Published online: 15 January 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Vascular grafting has progressed significantly in the pursuit of materials capable of achieving seamless biological integration with host tissue; however, an ideal graft that combines availability, durability, and biocompatibility remains elusive. This review provides a comprehensive overview of currently available biomaterials in vascular surgery, highlighting their clinical applications, benefits, and limitations. While autologous material (e.g., veins) remains the gold standard, its limited availability and harvesting-related morbidity, such as infection and thrombosis, have prompted the search for alternative biological grafts. Xenografts, derived from non-human donors (e.g., bovine, ovine, & porcine tissues), have demonstrated favorable patency rates and relatively low infection rates in vascular access, extremity revascularization, and aortic surgery. Human allografts have shown excellent performance in infected fields; however, their use is constrained by logistical challenges, including limited donor availability and labor-intensive preparation. Emerging tissue-engineered vascular grafts (TEVGs), often composed of biodegradable scaffolds seeded with biologically active cells, aim to replicate the structure and function of native vessels. Some TEVGs are designed to transform into native vasculature following biodegradation of the scaffold. However, further technical refinement and cost reduction are essential before TEVGs can be widely adopted as off-the-shelf solutions.

Keywords
Allograft
Biomaterials
Polytetrafluoroethylene
Vascular surgery
Xenograft
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