Drug-eluting stent with improved durability and controllability properties, obtained via electrocoated adhesive promotion layer

Surface grafting of poly-L-lysine via diazonium chemistry to enhance cell adhesion to biomedical electrodes

The ability to study and regulate cell behavior at a biomaterial interface requires a strict control over its surface chemistry. Significance of studying cell adhesion in vitro and in vivo has become increasingly important, particularly in the field of tissue engineering and regenerative medicine. A promising surface modification route assumes using organic layers prepared by the method of electrografting of diazonium salts and their further functionalization with biologically active molecules as cell adhesion promoters. This work reports the modification of platinum electrodes with selected diazonium salts and poly-L-lysine to increase the number of sites available for cell adhesion. As-modified electrodes were characterized in terms of their chemical and morphological properties, as well as wettability. In order to monitor the process of cell attachment, biofunctionalized electrodes were used as substrates for culturing human neuroblastoma SH-SY5Y cells. The experiments revealed that cell adhesion is favored on the surface of diazonium-modified and poly-L-lysine coated electrodes, indicating proposed modification route as a valuable strategy enhancing the integration between bioelectronic devices and neural cells.

Drug-Eluting Stents and Balloons-Materials, Structure Designs, and Coating Techniques: A Review

Controlled drug delivery is a matter of interest to numerous scientists from various domains, as well as an essential issue for society as a whole. In the treatment of many diseases, it is crucial to control the dosing of a drug for a long time and thus maintain its optimal concentration in the tissue. Heart diseases are particularly important in this aspect. One such disease is an obstructive arterial disease affecting millions of people around the world. In recent years, stents and balloon catheters have reached a significant position in the treatment of this condition. Balloon catheters are also successfully used to manage tear ducts, paranasal sinuses, or salivary glands disorders. Modern technology is continually striving to improve the results of previous generations of stents and balloon catheters by refining their design, structure, and constituent materials. These advances result in the development of both successive models of drug-eluting stents (DES) and drug-eluting balloons (DEB). This paper presents milestones in the development of DES and DEB, which are a significant option in the treatment of coronary artery diseases. This report reviews the works related to achievements in construction designs and materials, as well as preparation technologies, of DES and DEB. Special attention was paid to the polymeric biodegradable materials used in the production of the above-mentioned devices. Information was also collected on the various methods of producing drug release coatings and their effectiveness in releasing the active substance.

Electrochemical Strategies for Titanium Implant Polymeric Coatings: The Why and How

Among the several strategies aimed at polymeric coatings deposition on titanium (Ti) and its alloys, metals commonly used in orthopaedic and orthodontic prosthesis, electrochemical approaches have gained growing interest, thanks to their high versatility. In this review, we will present two main electrochemical procedures to obtain stable, low cost and reliable polymeric coatings: electrochemical polymerization and electrophoretic deposition. Distinction should be made between bioinert films—having mainly the purpose of hindering corrosive processes of the underlying metal—and bioactive films—capable of improving biological compatibility, avoiding inflammation or implant-associated infection processes, and so forth. However, very often, these two objectives have been pursued and achieved contemporaneously. Indeed, the ideal coating is a system in which anti-corrosion, anti-infection and osseointegration can be obtained simultaneously. The ultimate goal of all these coatings is the better control of properties and processes occurring at the titanium interface, with a special emphasis on the cell-coating interactions. Finally, advantages and drawbacks of these electrochemical strategies have been highlighted in the concluding remarks.

Cardiovascular stents: overview, evolution, and next generation

Compared to bare-metal stents (BMSs), drug-eluting stents (DESs) have been regarded as a revolutionary change in coronary artery diseases (CADs). Releasing pharmaceutical agents from the stent surface was a promising progress in the realm of cardiovascular stents. Despite supreme advantages over BMSs, in-stent restenosis (ISR) and long-term safety of DESs are still deemed ongoing concerns over clinically application of DESs. The failure of DESs for long-term clinical use is associated with following factors including permanent polymeric coating materials, metallic stent platforms, non-optimal drug releasing condition, and factors that have recently been supposed as contributory factors such as degradation products of polymers, metal ions due to erosion and degradation of metals and their alloys utilizing in some stents as metal frameworks. Discovering the direct relation between stent materials and associating adverse effects is a complicated process, and yet it has not been resolved. For clinical success it is of significant importance to optimize DES design and explore novel strategies to overcome all problems including inflammatory response, delay endothelialization, and sub-acute stent thrombosis (ST) simultaneously. In this work, scientific reports are reviewed particularly focusing on recent advancements in DES design which covers both potential improvements of existing and recently novel prototype stent fabrications. Covering a wide range of information from the BMSs to recent advancement, this study mostly sheds light on DES's concepts, namely stent composition, drug release mechanism, and coating techniques. This review further reports different forms of DES including fully biodegradable DESs, shape-memory ones, and polymer-free DESs.

Protective Layer Development for Enhancing Stability and Drug-Delivery Capabilities of DES Surface-Crystallized Coatings

Carrier-free drug-eluting stents (DES)-based crystalline coatings are gaining prominence because of their function, skipping many limitations and clinical complications of the currently marketed DES. However, their usage has been humbled by inflexibility of the crystalline coating and limited mechanical and physical properties. This study reports for the first time the development of a protective top coating for enhancing the merits and delivery capabilities of the crystalline coating. Flexible and water-soluble polysaccharide top coating was developed and applied onto rapamycin (RM) crystalline carpet. The top coating prevented crystalline coating delamination during stent crimping and expansion without affecting its release profile. Crystalline coating strata and its interfaces with the metallic substrate and top coating were fully studied and characterized. The crystalline top-coated stents showed significant physical, mechanical, and chemical stability enhancement with ∼2% RM degradation after 1 year under different storage conditions. Biocompatibility study of the top-coated stents implanted subcutaneously for 1 month into SD rats did not provoke any safety concerns. Incorporating RM into the top coating to develop a bioactive protective coating for multilayer release purposes was also investigated. The developed protective coating had wide applicability and may be further implemented for various drugs and implantable medical devices.

Multifunctional and Stable Monolayers on Carbon: A Simple and Reliable Method for Backfilling Sparse Layers Grafted from Protected Aryldiazonium Ions

A new strategy for preparation of robust multifunctional low nanometer thickness monolayers on carbon substrates is presented. Beginning with protected aryldiazonium salts, sparse monolayers of ethynyl-, amino-, and carboxy-terminated tethers are covalently anchored to the surface. The layers are then backfilled with a second modifier via the nucleophilic addition of an amine derivative to the surface. Through use of electroactive moieties coupled to the tethers, and an electroactive amine for backfilling, electrochemical measurements reveal that backfilling approximately doubles the surface concentration of the monolayer. Cyclic voltammetry of solution-based redox probes at the modified surfaces is consistent with the expected blocking properties at various stages of surface preparation. Fractional surface coverages of the layers are estimated using electrochemically determined surface concentrations of modifiers and computationally derived modifier footprints. Assuming free rotation of the coupled ferrocenyl or nitrophenyl groups leads to physically unreasonable fractional surface coverages, indicating that these larger modifiers must be rotationally restricted. Using a conformationally constrained model produces lower bound estimates of the total fractional surface coverage close to 0.4, with tether-only coverages close to 0.2. The backfilled tether layers constitute practical platforms for controlled construction of complex interfaces with many potential applications including sensing, molecular electronics, and catalysis.

Effects of interfacial layer wettability and thickness on the coating morphology and sirolimus release for drug-eluting stent

Drug-eluting stents (DESs) have been used to treat coronary artery diseases by placing in the arteries. However, current DESs still suffer from polymer coating defects such as delamination and peeling-off that follows stent deployment. Such coating defects could increase the roughness of DES and might act as a source of late or very late thrombosis and might increase the incident of restenosis. In this regard, we modified the cobalt-chromium (Co-Cr) alloy surface with hydrophilic poly(2-hydroxyethyl methacrylate) (PHEMA) or hydrophobic poly(2-hydroxyethyl methacrylate)-grafted-poly(caprolactone) (PHEMA-g-PCL) brushes. The resulting surfaces were biocompatible and biodegradable, which could act as anchoring layer for the drug-in-polymer matrix coating. The two modifications were characterized by ATR-FTIR, XPS, water contact angle measurements, SEM and AFM. On the control and modified Co-Cr samples, a sirolimus (SRL)-containing poly(D,L-lactide) (PDLLA) were ultrasonically spray-coated, and the drug release was examined for 8weeks under physiological conditions. The results demonstrated that PHEMA as a primer coating improved the coating stability and degradation morphology, and drug release profile for short-term as compared to control Co-Cr, but fails after 7weeks in physiological buffer. On the other hand, the hydrophobic PHEMA-g-PCL brushes not only enhanced the stability and degradation morphology of the PDLLA coating layer, but also sustained SRL release for long-term. At 8-week of release test, the surface morphologies and release profiles of coated PDLLA layers verified the beneficial effect of hydrophobic PCL brushes as well as their thickness on coating stability. Our study concludes that 200nm thickness of PHEMA-g-PCL as interfacial layer affects the stability and degradation morphology of the biodegradable coating intensively to be applied for various biodegradable-based DESs.

Crack prevention of biodegradable polymer coating on metal facilitated by a nano-coupled interlayer

Crack prevention of biodegradable polymer coatings on drug-eluting stents was investigated by introducing a nano-coupled layer at the interface between the metal surface and the polymer coating layer using surface-initiated ring-opening polymerization of ε-caprolactone. Poly(d,l-lactide-co-glycolide) coating on cobalt-chromium control and ricinoleic acid-poly(caprolactone)–grafted cobalt-chromium was carried out using electrospraying. The cracking of the biodegradable polymer coating on drug-eluting stents during ballooning was addressed by introducing a nano-coupled interlayer on the cobalt-chromium surface. The ricinoleic acid-poly(caprolactone) nano-coupled interlayer and poly(d,l-lactide-co-glycolide)-coated top layer were characterized using attenuated total reflection Fourier transform infrared, contact angle, ellipsometry, X-ray photoelectron spectroscopy, and atomic force microscopy. Based on scratch tests, the nano-coupled samples had stronger interfacial adhesion compared to the control sample without the nano-coupled layer. Scanning electron microscope images indicated that the cracking on the poly(d,l-lactide-co-glycolide) coating was addressed. Introducing a nano-coupling interlayer may be an important strategy to preventing polymer coating cracking on drug-eluting stents.

Reinforcement of interfacial adhesion of a coated polymer layer on a cobalt-chromium surface for drug-eluting stents

During the balloon expansion of several commercially available drug-eluting stents, various types of defects in the polymer layer have been observed. The aim of this study is to prevent these defects by increasing the interfacial adhesion between the metal substrate and the drug-in-polymer matrix using poly(caprolactone) (PCL) brushes onto a cobalt-chromium (Co-Cr or CC) alloy surface. The chemical modification of the Co-Cr surface was accomplished by grafting ricinoleic acid (RA) onto the metal substrate followed by surface-initiated ring opening polymerization of ε-caprolactone. The unmodified, RA-grafted (CC-RA), and PCL-grafted Co-Cr substrates (CC-RA-PCL3D and CC-RA-PCL6D) were characterized by various surface analyses. Poly(d,l-lactide) containing sirolimus was spray coated onto the unmodified and modified substrates. The adhesion property of the polymer coating on the PCL-grafted surfaces was improved compared to those of other samples. Among all of the drug-in-polymer coated samples, both CC-RA-PCL3D and CC-RA-PCL6D exhibited a stabilized drug release profile over 49 days. It was also revealed that CC-RA-PCL6D showed the slowest drug release of all the samples. On the basis of these results, the proposed nanocoupling method has shown not only improved adhesion of the drug-in-polymer matrix to the Co-Cr substrate but also controlled drug release.

Paclitaxel-loaded poly(lactide-co-glycolide)/poly(ethylene vinyl acetate) composite for stent coating by ultrasonic atomizing spray

The mixture of poly(lactide-co-glycolide) (PLGA) and poly(ethylene vinyl acetate) (PEVA) forms a homogeneous liquid in an organic solvent such as tetrahydrofuran, and a phase-separated PLGA/PEVA composite can be prepared from it by evaporating the organic solvent. Exploiting this phenomenon, we designed a novel method of preparing a drug-loaded PLGA/PEVA composite and used it for coating drug-eluting stents (DESs). Paclitaxel (PTX), an anticancer drug, was chosen as a model drug. PLGA acts as a microdepot for PTX, and PEVA provides mechanical strength to the coating material. The presence of PLGA in the PLGA/PEVA composite suppressed PTX crystallization in the coating material, and PTX showed a sustained release rate over more than 30 days. The mechanical strength of the PLGA/PEVA composite was better than that of PEVA used as a control. After coating the stent with a PLGA/PEVA composite using ultrasonic atomizing spray, the morphology of the coated material was observed by scanning electron microscopy, and the release pattern of PTX was measured by high-performance liquid chromatography.