What is Atherosclerosis?

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Atherosclerosis is an inflammatory disease that causes formation of plaques under the intimal layer of the blood vessel wall. As the plaque grows and calcifies, it narrows the blood vessel lumen and decreases blood flow to the downstream tissue. Also, risk of plaque rupture increases. Plaque rupture leads to platelet adhesion that results in a thrombus, which occludes the artery. Occlusion of the coronary arteries results in myocardial infarction. Pathologies affecting small and medium sized arteries are the leading cause of death worldwide. Due to development of better treatments, mortality rates after myocardial infarction have decreased in the last decades (REF). However, replacement of the occluded artery is often necessary. The currently available options for these transplants are limited. The most frequently applied treatment for coronary artery occlusion is a bypass operation. During this operation, an autologous blood vessel (often a saphenous vein or a mammary artery) is used to bypass the coronary artery. The use of these so-called autografts is invasive and may be limited due to previous harvesting and anatomical variability. Furthermore, atherosclerosis is often found in almost all blood vessels of the patient. The risk of occlusion of the autograft is high (Hasan et al., 2014).

Developments in tissue engineering allow for the creation of new vascular grafts from synthetic or natural polymers and patient derived cells. Given the occurrence of
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