In vitro exposure of a novel polyesterurethane graft to enzymes: a study of the biostability of the Vascugraft arterial prosthesis

Biodegradable, Self-Reinforcing Vascular Grafts for In Situ Tissue Engineering Approaches

Clinically available small-diameter synthetic vascular grafts (SDVGs) have unsatisfactory patency rates due to impaired graft healing. Therefore, autologous implants are still the gold standard for small vessel replacement. Bioresorbable SDVGs may be an alternative, but many polymers have inadequate biomechanical properties that lead to graft failure. To overcome these limitations, a new biodegradable SDVG is developed to ensure safe use until adequate new tissue is formed. SDVGs are electrospun using a polymer blend composed of thermoplastic polyurethane (TPU) and a new self-reinforcing TP(U-urea) (TPUU). Biocompatibility is tested in vitro by cell seeding and hemocompatibility tests. In vivo performance is evaluated in rats over a period for up to six months. Autologous rat aortic implants serve as a control group. Scanning electron microscopy, micro-computed tomography (µCT), histology, and gene expression analyses are applied. TPU/TPUU grafts show significant improvement of biomechanical properties after water incubation and exhibit excellent cyto- and hemocompatibility. All grafts remain patent, and biomechanical properties are sufficient despite wall thinning. No inflammation, aneurysms, intimal hyperplasia, or thrombus formation are observed. Evaluation of graft healing shows similar gene expression profiles of TPU/TPUU and autologous conduits. These new biodegradable, self-reinforcing SDVGs may be promising candidates for clinical use in the future.

Polyurethane Recycling and Disposal: Methods and Prospects

Growing water and land pollution, the possibility of exhaustion of raw materials and resistance of plastics to physical and chemical factors results in increasing importance of synthetic polymers waste recycling, recovery and environmentally friendly ways of disposal. Polyurethanes (PU) are a family of versatile synthetic polymers with highly diverse applications. They are class of polymers derived from the condensation of polyisocyanates and polyalcohols. This paper reports the latest developments in the field of polyurethane disposal, recycling and recovery. Various methods tested and applied in recent years have proven that the processing of PU waste can be economically and ecologically beneficial. At the moment mechanical recycling and glycolysis are the most important ones. Polyurethanes' biological degradation is highly promising for both post-consumer and postproduction waste. It can also be applied in bioremediation of water and soil contaminated with polyurethanes. Another possibility for biological methods is the synthesis of PU materials sensitive to biological degradation. In conclusion, a high diversity of polyurethane waste types and derivation results in demand for a wide range of methods of processing. Furthermore, already existing ones appear to be enough to state that the elimination of not reprocessed polyurethane waste in the future is possible.

Development of a YIGSR-peptide-modified polyurethaneurea to enhance endothelialization

Polyurethanes have been investigated for use as vascular grafts due to their excellent mechanical properties and relatively good biocompatibility. However, poor retention of endothelial cells and thrombogenicity in vivo remain problematic for vascular graft applications. The peptide YIGSR has been shown to increase endothelial cell adhesion but not attachment of platelets, suggesting its possible utility for vascular graft applications. In this study, a bioactive polyurethaneurea has been synthesized by incorporating GGGYIGSRGGGK peptide sequences into the polymer backbone. Successful incorporation of the peptides was confirmed by NMR, contact angle measurement and ESCA. Uniform distribution of peptides on the surface was observed using a fluorescent probe capable of reacting with tyrosine residues on the peptides. Hard segment domains were visualized using tapping mode AFM. Endothelial cell adhesion, spreading, proliferation, migration and extra-cellular matrix production were improved on bioactive polyurethaneurea compared to control polyurethaneurea. Competitive inhibition of endothelial cell attachment and spreading by soluble YIGSR peptides indicated that cell adhesion and spreading were specifically mediated by YIGSR-sensitive cell adhesion receptor, not just by changed surface properties. There was no significant difference in the number of adherent platelets. Therefore, this bioactive polyurethanurea may improve vascular graft endothelialization without increasing thrombogenicity.

Fluoropassivation and gelatin sealing of polyester arterial prostheses to skip preclotting and constrain the chronic inflammatory response

Fluoropassivation and gelatin coating have been applied to polyethylene terephthalate (PET) vascular prosthesis to combine the advantages of both polytetrafluoroethylene (PTFE) and PET materials, and to eliminate the preclotting procedure. The morphological, chemical, physical, and mechanical properties of such prostheses were investigated and compared with its original model. Fluoropassivation introduced -OCF(3), -CF(3), and -CFCF(2)- structures onto the surface of the polyester fibers. However, the surface fluorine content was only 28-32% compared to the 66% in expanded PTFE (ePTFE) grafts. The fluoropassivation decreased the hydrophilicity, slightly increased the water permeability, and marginally lowered the melting point and the crystallinity of the PET fibers. After gelatin coating, the fluoropassivated and nonfluoropassivated prostheses showed similar surface morphology and chemistry. While gelatin coating eliminated preclotting, it also renders the prostheses slightly stiffer. The original prosthesis had the highest bursting strength (275 N), with the fluoropassivated and gelatin-sealed devices showing similar bursting strength between 210 and 230 N. Fluoropassivation and gelatin coating lowered the retention strength by 23 and 30% on average, respectively. In vitro enzymatic incubation had only marginal effect on the surface fluorine content of the nongelatin-sealed prostheses. However, the gelatin-sealed ones significantly lost their surface fluorine after in vitro enzymatic incubation (by 69-85%) or in vivo 6-month implantation (by 51-60%), showing the lability of the fluoropolymer layer under the hostile biological environment.

RGD peptide-immobilized electrospun matrix of polyurethane for enhanced endothelial cell affinity

An Arg-Gly-Asp (RGD) peptide-immobilized electrospun matrix of polyurethane (PU) was developed for the enhanced affinity of endothelial cells (EC). The novel PU matrix was fabricated as a vascular shape using the electrospinning technique. Then, poly(ethylene glycol) (PEG) was immobilized on the porous PU matrix as a spacer, followed by conjugating RGD peptide to the amino end group of the PEG chain. In the proliferation test of human umbilical vein endothelial cells (HUVEC) on the modified PU matrix, the RGD-immobilized porous matrix showed enhanced viability of HUVEC as compared with an unmodified surface, demonstrating that the presence of RGD peptide promoted HUVEC proliferation. In addition, the RGD-immobilized PU porous matrix revealed higher cell viability than the RGD-immobilized PU film because of the porous structure with higher surface area, indicating an advantageous property of the porous matrix for HUVEC proliferation.

Synthesis and characterization of fluorocarbon chain end-capped poly(carbonate urethane)s as biomaterials: A novel bilayered surface structure

Poly(carbonate urethane)s (PCUs) are usually considered as biostable elastomers for long-term implantation. However, their hydrolytic stability is still questionable. The biodegradation appears to be initiated by oxidative and hydrolytic substances released by inflammatory cells. Therefore, the biostability of polyurethane might be improved with control of surface structure to reduce inflammatory response. A new type of PCUs end-capped with perfluoro chains was synthesized to explore a new avenue. A fluorinated alcohol, 2,2,3,3,4,4,5,5,6,6,7,7,8,8,8-pentadecafluoro-1-octanol (PDFOL), was end-capped to the backbones of PCUs by reaction of the --OH in PDFOL with the --NCO end groups in PCU backbones. Contact angle measurement, X-ray photoelectron spectroscopy, atomic force microscopy, and attenuated total reflectance-Fourier transform infrared spectroscopy were used to examine their surface structure and properties. Elemental analysis, gel permeation chromatography, differential scanning calorimetry, and tensile testing were used to assess bulk chemistry and properties. The fluorocarbon end-capped poly (carbonate urethane)s (FPCUs) maintained the high mechanical properties (about 40 MPa tensile strength) and typical microphase separation structure of polyurethane elastomers. Results from surface analyses revealed the presence of a double-layered structure at the surfaces of the FPCUs. The first one was composed of fluorocarbon tails rising up on the uppermost layer and the second one made up of hard-segments. This novel bilayered surface structure could protect the weak carbonate linkages in soft segments, and consequently, may potentially increase the biostability of this kind of polyurethanes.

Modified polycarbonate urethane: synthesis, properties and biological investigation in vitro

A new polycarbonate urethane (PCU-I) was synthesized from aliphatic monomers, i.e. polyhexamethylene carbonate diol and 4,4'-methylene-bis cyclohexane diisocyanate, a mixture of low molecular diols, and castor oil (containing mainly the triglyceride of 12-hydroxyoleic acid). The second synthesized polymer (PCU-II) did not contain castor oil. Both PCUs had good tensile strength, i.e. 32.5 and 27.8 MPa for PCU-I and PCU-II, respectively. Modification by castor oil led to a decrease in glass transition temperature (T(g) = -14 degrees C for PCU-I and -6 degrees C for PCU-II) and an increase in the softening temperature (135 and 125 degrees C for PCU-I and PCU-II, respectively). Partial crosslinking of PCU-I increased the storage modulus of elasticity and provided better resistance to sterilization by ETO and gamma radiation. Both PCUs displayed good stability when subjected to sterilization by hydrogen peroxide plasma. Neither PCU caused cytotoxic effect in mouse fibroblasts (3T3 Balb C). They also had no toxic effects on the morphotic components and did not influence changes in the hematologic parameters or plasmatic coagulation system of human blood.

Long-term in vivo biostability of poly(dimethylsiloxane)/poly(hexamethylene oxide) mixed macrodiol-based polyurethane elastomers

The long-term biostability of a novel thermoplastic polyurethane elastomer (Elast-Eon 2 80A) synthesized using poly(hexamethylene oxide) (PHMO) and poly(dimethylsiloxane) (PDMS) macrodiols has been studied using an in vivo ovine model. The material's biostability was compared with that of three commercially available control materials, Pellethane 2363-80A, Pellethane 2363-55D and Bionate 55D, after subcutaneous implantation of strained compression moulded flat sheet dumbbells in sheep for periods ranging from 3 to 24 months. Scanning electron microscopy, attenuated total reflectance-Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy were used to assess changes in the surface chemical structure and morphology of the materials. Gel permeation chromatography, differential scanning calorimetry and tensile testing were used to examine changes in bulk characteristics of the materials. The results showed that the biostability of the soft flexible PDMS-based test polyurethane was significantly better than the control material of similar softness, Pellethane 80A, and as good as or better than both of the harder commercially available negative control polyurethanes, Pellethane 55D and Bionate 55D. Changes observed in the surface of the Pellethane materials were consistent with oxidation of the aliphatic polyether soft segment and hydrolysis of the urethane bonds joining hard to soft segment with degradation in Pellethane 80A significantly more severe than that observed in Pellethane 55D. Very minor changes were seen on the surfaces of the Elast-Eon 2 80A and Bionate 55D materials. There was a general trend of molecular weight decreasing with time across all polymers and the molecular weights of all materials decreased at a similar relative rate. The polydispersity ratio, Mw/Mn, increased with time for all materials. Tensile tests indicated that UTS increased in Elast-Eon 2 80A and Bionate 55D following implantation under strained conditions. However, ultimate strain decreased and elastic modulus increased in the explanted specimens of all three materials when compared with their unimplanted unstrained counterparts. The results indicate that a soft, flexible PDMS-based polyurethane synthesized using 20% PHMO and 80% PDMS macrodiols has excellent long-term biostability compared with commercially available polyurethanes.

Hydrogels based on poly(ethylene oxide) and poly(tetramethylene oxide) or poly(dimethyl siloxane). III. In vivo biocompatibility and biostability

To investigate the effects of polymer chemistry and topology (linear or graft copolymer) on in vivo biocompatibility and biostability based on cage implant system, various hydrogels, composed of short hydrophilic [polyethylene oxide (PEO)] and hydrophobic block, were prepared by polycondensation reaction. Poly(tetramethylene oxide) (PTMO) or poly(dimethyl siloxane) (PDMS) was chosen as a hydrophobic block because of their wide utilization as a biomaterial. By using the specimens retrieved from rats killed after 1, 2, 3, 5, and 7 weeks' implantation, cellular and material responses were assessed. Most hydrogels showed a comparable value of macrophage density to Pellethane(R), control polymer, whereas they did significantly lower foreign body giant cell (FBGC) density and coverage because of the presence of PEO. However, PEO block length and polymer topology did not affect macrophage adhesion and FBGC formation in our polymer composition. The hydrogel based on PDMS alone showed significantly lower macrophage density and FBGC density than Pellethane(R), indicating that PDMS plays a role in inhibiting cellular adhesion. The results obtained from gel permeation chromatography curve and Fourier transform infrared spectra exhibited that all the polymers were susceptible to oxidative degradation in vivo. Although Pellethane(R) revealed surface degradation by 5 weeks in vivo, hydrogels showed rapid degradation in the bulk within 2 weeks because of the penetration of oxidative chemicals released from phagocytic cells into PEO domain of phase-separated hydrogels. The more significant degradation was observed in the hydrogels with longer PEO block and PTMO as a hydrophobic block instead of PDMS. It was evident that the minor degradation could be achieved by grafting PEO and adopting PDMS as a hydrophobic block in the hydrogel.

Totally implantable artificial hearts and left ventricular assist devices: selecting impermeable polycarbonate urethane to manufacture ventricles

In the development of a new generation of totally implantable artificial hearts and left ventricular assist devices (VADs) for long-term use, the selection of an acceptable material for the fabrication of the ventricles probably represents one of the greatest challenges. Segmented polyether urethanes used to be the material of choice due to their superior flexural performance, acceptable blood compatibility, and ease of processing. However, because they are known to degrade and to be readily permeable to water, they cannot meet the rigorous requirements needed for a new generation of implantable artificial hearts and VADs. Therefore, the objective of the present study was to identify alternative polymeric materials that would be satisfactory for fabricating the ventricles, and in particular, to determine the water permeability through membranes made from four commercial polycarbonate urethanes (Carbothane PC3570A, Chronoflex AR, Corethane 80A, and Corethane 55D) in comparison to those made from two traditional polyether urethanes (Tecoflex EG80A and Tecothane TT-1074A). In addition to determining the rate of water transmission through the six membranes by exposing them to deionized water, saline, and albumin-Krebs solution under pressure and measuring the displacement of liquid by means of a recently developed capillary method, the inherent surface and chemical properties of the six membranes were characterized by SEM, contact angle measurements, FTIR, DSC, and GPC techniques. The results of the study demonstrated that the rate of water transmission through the four polycarbonate urethane membranes was significantly lower than through the two polyether urethanes. In fact the lowest values were recorded with the two Corethane membranes, and the harder type 55D polymer had a lower value (2.7 x 10(-7) g/s cm2) than the softer 80A version (3.3 x 10(-7) g/s cm2). This level of water vapor permeability, which appears to be controlled primarily by a Fickian diffusion mechanism, is between 2 and 4 times lower than that obtained with traditional polyether urethane membranes of equivalent thickness. The superior performance of the polycarbonate urethanes is likely due to the inherently lower chain mobility of the carbonate structure in the soft segment phase. In addition, the study shows that additional impermeability to water vapor can be achieved by selecting a polyurethane polymer with a high hard segment content, an aromatic rather than aliphatic diisocyanate comonomer, and a more hydrophobic surface. The use of a higher molecular weight polyurethane is not necessarily efficacious if the above requirements are not met. As expected by Raoult's Law, the study found that the use of physiological media instead of deionized water further decreases the rate of water vapor transmission. Because none of today's commercial polyurethanes are totally impervious to water vapor transmission, additional work is needed to develop permeable polymers or to apply additional treatments to existing candidates to achieve an acceptable impermeable ventricle material.

A new generation of polyurethane vascular prostheses: rara avis or ignis fatuus?

Three polyurethane (PU) vascular grafts with novel designs were investigated and compared in terms of the microporous structure, reinforcement technology, polymer chemistry, microphase separation, and mechanical properties. The Corvita graft, composed of a poly(carbonate urethane) polymer, displayed a helically wound filament structure with communicating inter-fiber spaces. The reinforced model contained an external PET mesh impregnated with a protein sealant, and displayed good microphase separation, the highest Young's modulus in the longitudinal direction, and the second highest in the radial direction. The Thoratec graft was made of a polyetherurethaneurea with an average micropore size of 15 microns. Silicone was observed on both surfaces of the graft. The Thoratec device displayed a low degree of hydrogen-bonding among the urethane groups and had no well-organized hard-segment domains. Its mechanical strength was superior to that of the Pulse-Tec graft. A solid PU layer underneath the luminal surface precluded any communication between the luminal and adventitial sides. The Pulse-Tec prosthesis was composed of polyetherurethane, with an average micropore size of 28 microns. It offered the highest radial compliance, a high degree of hydrogen-bonding, a narrow molecular weight distribution, and a certain degree of microphase separation. Its tensile strength and hysteresis loss were inferior to those of the other two grafts.

Hydrolytic and enzymatic incubation of polyhydroxyoctanoate (PHO): a short-term in vitro study of a degradable bacterial polyester

The present study examined the degradation behaviour of poly(beta-hydroxy octanoate) (PHO), a bacterial poly(beta-hydroxy alkanoate), following incubation under hydrolytic or enzymatic conditions in vitro. Solution-cast PHO films were incubated in a citrate buffer solution with and without acid phosphatase and in an acetate buffer with and without beta-glucuronidase for periods ranging from 7 to 60 days. The physical characterization of the PHO films was analyzed by SEM and tensile strength studies. In addition, various analytical methods were used to detect modifications in the chemical and morphological structure of the PHO, namely, ESCA, FTIR, DSC, X-ray diffraction, and SEC. The results indicate that the enzymatic conditions selected in the present study induced no significant surface morphological or chemical modifications, and no significant weight loss was observed after 60 days of incubation. However, as revealed by weight average molecular weight Mw and number average molecular weight Mn decreases, changes in the bulk structure of the PHO were observed with acid phosphatase at 28 and 60 days, in contrast to smaller Mw and Mn decreases recorded in both the buffers and the beta-glucuronidase. The tensile properties had decreased following incubation, yet showed no difference under all of the selected conditions. With no weight loss or surface changes, the PHO films incubated in acid phosphatase showed only a chemical hydrolytic process characterized by Mw and Mn decreases with time of incubation. The present study demonstrated that the degradation of PHO films is one of slow, chemical hydrolysis only, perhaps requiring several months of incubation. The hydrophobic nature of the long alkyl pendent chain in PHO may be responsible for this slow process. The inability of enzymes to degrade PHO may be attributed to the latter's poor adsorption capacity, due to its hydrophobic nature, and to a lack of specificity in the catalytic activity of these enzymes.

Elastomers for biomedical applications

Current topics in elastomers for biomedical applications are reviewed. Elastomeric biomaterials, such as silicones, thermoplastic elastomers, polyolefin and polydiene elastomers, poly(vinyl chloride), natural rubber, heparinized polymers, hydrogels, polypeptides elastomers and others are described. In addition biomedical applications, such as cardiovascular devices, prosthetic devices, general medical care products, transdermal therapeutic systems, orthodontics, and ophthalmology are reviewed as well. Elastomers will find increasing use in medical products, offering biocompatibility, durability, design flexibility, and favorable performance/cost ratios. Elastomers will play a key role in medical technology of the future.

Vascugraft polyurethane arterial prosthesis as femoro-popliteal and femoro-peroneal bypasses in humans: pathological, structural and chemical analyses of four excised grafts

Following positive results obtained in in vitro studies and in vivo implantations in animals, a clinical trial using the Vascugraft polyurethane arterial prosthesis as a below-knee substitute was undertaken in 15 patients. Eight grafts became occluded during the first year, and segments from four of them were explanted and made available for pathological, structural and chemical investigations. The implantation periods ranged from 21 to 358 days. Failures were associated with kinking (one case), possible anastomotic mismatch between the graft and the artery (one case), and poor run-off (two cases). No organized collagenous internal encapsulation was noted; however, endothelial-like cells were observed at the anastomotic site of one graft. No significant structural degradation of the prostheses was observed in those grafts implanted for 21, 38 and 46 days. Some deteriorations in the fibrous structure were observed on the external surface of the prosthesis implanted for 358 days. High-resolution carbon C1s analysis by ESCA demonstrated a 60 to 80% decrease in carbonate content on the surface of all explanted prostheses. Chemical analyses of each polyurethane graft by IR, SEC and DSC revealed no significant chemical changes. The clinical performance of the Vascugraft prosthesis for below-knee implantation proved to be no more impressive than that of expanded polytetrafluorethylene, the currently accepted reference. The decision by B. Braun Melsungen AG to end this program is therefore to be regarded as highly professional.

Chemical and morphological analysis of explanted polyurethane vascular prostheses: the challenge of removing fixed adhering tissue

During in vivo experiments to evaluate the biocompatibility and biostability of alternative biomaterials, the ideal protocol for the handling and preservation of the explanted material is often compromised in order to meet the needs of both the pathologist and the materials scientist. Explants surrounded by tissue are often fixed in formalin or glutaraldehyde to facilitate later pathological and histological analysis, but the subsequent removal of such fixed tissue from thermally sensitive and less chemically stable polymers, such as polyurethanes, poses major problems for the materials scientist, who does not wish to modify the chemical, physical or morphological characteristics of the underlying biomaterial. The present study has attempted to find a solution to this problem by exposing virgin specimens of the microporous polyurethane Vascugraft vascular prosthesis to six different cleaning conditions, all known to be effective in removing fixed tissue. These conditions included the use of 20% aqueous potassium hydroxide solution for 48 h at room temperature, 5% sodium bicarbonate solution for 5 min at the boil, and 9, 10, 11 and 12N hydrochloric acid for 48 h at room temperature. The appearance and chemical properties of the virgin and treated specimens were compared using electron spectroscopy for chemical analysis, Fourier transform infrared spectroscopy, gel permeation chromatography for molecular weight and differential scanning calorimetry techniques. The use of temperatures close to the boil resulted in the formation of a translucent, rubbery material with gross changes in the microporous and microfibrous structure. The strongly acidic and alkaline conditions caused a loss in the surface carbonate group content. In addition, 12N hydrochloric acid reduced the molecular weight and urethane content. Consequently, 9N hydrochloric acid is recommended as the cleaning agent of choice for removing fixed tissue from this type of microporous polyurethane. Control experiments on virgin material should also be included in any cleaning protocol.