From structural mimicry to functional maturation: Advances in functional vascular 3D bioprinting.

Vascularization is a core bottleneck restricting the clinical translation of 3D bioprinted tissues and organs. Current vascular bioprinting is undergoing a pivotal shift from simple structural mimicry to functional bionic reconstruction, yet structurally qualified printed vessels often fail in long-term in vivo patency and physiological function due to insufficient biological activity. This review systematically summarizes the recent research progress of functional vascular bioprinting, focusing on advanced functional biomaterials, cutting-edge printing technologies, and core functional optimization strategies. We first clarify the essential differences between structural printing and functional vascular construction and establish a standardized functional evaluation system for bioprinted vessels. This paper further elaborates on the design and optimization of smart composite bioinks; highlights emerging high-fidelity printing technologies including embedded suspension printing, field-assisted microscale printing, and in situ printing; and summarizes key strategies for vascular functional maturation, covering endothelial barrier reconstruction, antithrombotic/anti-inflammatory modification, mechanical domestication, and in vivo remodeling. We also discuss the latest biomedical applications, translational bottlenecks, and future development directions of intelligent biomaterials, multi-scale printing, and standardized translational systems. This review provides a systematic reference for promoting the transformation of vascular bioprinting from structural fabrication to clinical functional application, advancing the development of vascular regenerative medicine.